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1. Mapping development and health effects of cooking with solid fuels in low-income and middle-income countries, 2000–18: a geospatial modelling study

Author: Joseph Jon Frostad, QuynhAnh P Nguyen, Mathew M Baumann, Brigette F Blacker, Laurie B Marczak, Aniruddha Deshpande, Kirsten E Wiens, Kate E LeGrand, Kimberly B Johnson, Mohsen Abbasi-Kangevari, Amir Abdoli, Hassan Abolhassani, Lucas Guimarães Abreu, Michael R M Abrigo, Niveen ME Abu-Rmeileh, Victor Adekanmbi, Anurag Agrawal, Muktar Beshir Ahmed, Ziyad Al-Aly, Fahad Mashhour Alanezi, Jacqueline Elizabeth Alcalde-Rabanal, Vahid Alipour, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J Alvis-Zakzuk, Adeladza Kofi Amegah, Saeed Amini, Fatemeh Amiri, Dickson A Amugsi, Robert Ancuceanu, Catalina Liliana Andrei, Tudorel Andrei, Ernoiz Antriyandarti, Davood Anvari, Jalal Arabloo, Morteza Arab-Zozani, Seyyed Shamsadin Athari, Marcel Ausloos, Getinet Ayano, Yared Asmare Aynalem, Samad Azari, Ashish D Badiye, Atif Amin Baig, Kalpana Balakrishnan, Maciej Banach, Sanjay Basu, Neeraj Bedi, Michelle L Bell, Derrick A Bennett, Krittika Bhattacharyya, Zulfiqar A Bhutta, Sadia Bibi, Somayeh Bohlouli, Soufiane Boufous, Nicola Luigi Bragazzi, Dejana Braithwaite, Sharath Burugina Nagaraja, Zahid A Butt, Florentino Luciano Caetano dos Santos, Josip Car, Rosario Cárdenas, Felix Carvalho, Joao Mauricio Castaldelli-Maia, Carlos A Castañeda-Orjuela, Ester Cerin, Soosanna Kumary Chattu, Vijay Kumar Chattu, Pankaj Chaturvedi, Sarika Chaturvedi, Simiao Chen, Dinh-Toi Chu, Sheng-Chia Chung, Saad M A Dahlawi, Giovanni Damiani, Lalit Dandona, Rakhi Dandona, Aso Mohammad Darwesh, Jai K Das, Aditya Prasad Dash, Claudio Alberto Dávila-Cervantes, Diego De Leo, Jan-Walter De Neve, Getu Debalkie Demissie, Edgar Denova-Gutiérrez, Sagnik Dey, Samath Dhamminda Dharmaratne, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Isaac Oluwafemi Dipeolu, Fariba Dorostkar, Leila Doshmangir, Andre Rodrigues Duraes, Hisham Atan Edinur, Ferry Efendi, Maha El Tantawi, Sharareh Eskandarieh, Ibtihal Fadhil, Nazir Fattahi, Nelsensius Klau Fauk, Seyed-Mohammad Fereshtehnejad, Morenike Oluwatoyin Folayan, Masoud Foroutan, Takeshi Fukumoto, Abhay Motiramji Gaidhane, Mansour Ghafourifard, Ahmad Ghashghaee, Syed Amir Gilani, Tiffany K Gill, Alessandra C Goulart, Bárbara Niegia Garcia Goulart, Ayman Grada, Mohammed Ibrahim Mohialdeen Gubari, Davide Guido, Yuming Guo, Rajat Das Gupta, Rajeev Gupta, Reyna Alma Gutiérrez, Nima Hafezi-Nejad, Randah R Hamadeh, Ahmed I Hasaballah, Soheil Hassanipour, Khezar Hayat, Behzad Heibati, Reza Heidari-Soureshjani, Nathaniel J Henry, Claudiu Herteliu, Mehdi Hosseinzadeh, Mohamed Hsairi, Guoqing Hu, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Chidozie C D Iwu, Jalil Jaafari, Mihajlo Jakovljevic, Tahereh Javaheri, Ravi Prakash Jha, John S Ji, Jost B Jonas, Ali Kabir, Zubair Kabir, Rohollah Kalhor, Naser Kamyari, Tanuj Kanchan, Umesh Kapil, Neeti Kapoor, Gbenga A Kayode, Peter Njenga Keiyoro, Yousef Saleh Khader, Nauman Khalid, Ejaz Ahmad Khan, Maseer Khan, Md Nuruzzaman Khan, Khaled Khatab, Mona M Khater, Mahalaqua Nazli Khatib, Maryam Khayamzadeh, Jagdish Khubchandani, Gyu Ri Kim, Yun Jin Kim, Ruth W Kimokoti, Adnan Kisa, Sezer Kisa, Luke D Knibbs, Parvaiz A Koul, Ai Koyanagi, Kewal Krishan, G Anil Kumar, Manasi Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Faris Hasan Lami, Qing Lan, Savita Lasrado, Paolo Lauriola, Paul H Lee, Sonia Lewycka, Shanshan Li, Daiane Borges Machado, Phetole Walter Mahasha, Mina Maheri, Azeem Majeed, Afshin Maleki, Reza Malekzadeh, Deborah Carvalho Malta, Borhan Mansouri, Mohammad Ali Mansournia, Natalie Maria Martinez, Santi Martini, Francisco Rogerlândio Martins-Melo, Benjamin K Mayala, Man Mohan Mehndiratta, Walter Mendoza, Ritesh G Menezes, Endalkachew Worku Mengesha, Tuomo J Meretoja, Tomislav Mestrovic, Irmina Maria Michalek, Erkin M Mirrakhimov, Maryam Mirzaei, Roya Mirzaei, Babak Moazen, Yousef Mohammad, Abdollah Mohammadian-Hafshejani, Shafiu Mohammed, Ali H Mokdad, Lorenzo Monasta, Maziar Moradi-Lakeh, Paula Moraga, Lidia Morawska, Abbas Mosapour, Simin Mouodi, Amin Mousavi Khaneghah, Satinath Mukhopadhyay, Sandra B Munro, Christopher J L Murray, Ahamarshan Jayaraman Nagarajan, Mohsen Naghavi, Sanjeev Nair, Vinay Nangia, Bruno Ramos Nascimento, Javad Nazari, Ionut Negoi, Henok Biresaw Netsere, Josephine W Ngunjiri, Huong Lan Thi Nguyen, Jean Jacques Noubiap, Bogdan Oancea, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Ahmed Omar Bali, Obinna E Onwujekwe, Nikita Otstavnov, Stanislav S Otstavnov, Mayowa O Owolabi, Mahesh P A, Anamika Pandey, Eun-Cheol Park, Eun-Kee Park, Sangram Kishor Patel, Hai Quang Pham, Thomas Pilgrim, Meghdad Pirsaheb, Khem Narayan Pokhrel, Maarten J Postma, Zahiruddin Quazi Syed, Navid Rabiee, Amir Radfar, Fakher Rahim, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, Amir Masoud Rahmani, Chhabi Lal Ranabhat, Sowmya J Rao, Davide Rasella, Prateek Rastogi, Goura Kishor Rath, David Laith Rawaf, Salman Rawaf, Lal Rawal, Reza Rawassizadeh, Andre M N Renzaho, Bhageerathy Reshmi, Negar Rezaei, Nima Rezaei, Aziz Rezapour, Jennifer Rickard, Leonardo Roever, Luca Ronfani, Morteza Rostamian, Enrico Rubagotti, Godfrey M Rwegerera, Basema Saddik, Ehsan Sadeghi, Sahar Saeedi Moghaddam, Rajesh Sagar, Amirhossein Sahebkar, Biniyam Sahiledengle, Marwa Rashad Salem, Abdallah M Samy, Milena M Santric-Milicevic, Sivan Yegnanarayana Iyer Saraswathy, Brijesh Sathian, Thirunavukkarasu Sathish, David C Schwebel, Sadaf G Sepanlou, Saeed Shahabi, Amira A Shaheen, Izza Shahid, Masood Ali Shaikh, Ali S Shalash, Mehran Shams-Beyranvand, Mohammed Shannawaz, Kiomars Sharafi, Aziz Sheikh, Sara Sheikhbahaei, Ranjitha S Shetty, Wondimeneh Shibabaw Shiferaw, Mika Shigematsu, Jae Il Shin, K M Shivakumar, Soraya Siabani, Tariq Jamal Siddiqi, Balbir Bagicha Singh, Jasvinder A Singh, Yitagesu Sintayehu, Muluken Bekele Sorrie, Ireneous N Soyiri, Emma Elizabeth Spurlock, Chandrashekhar T Sreeramareddy, Leo Stockfelt, Mu'awiyyah Babale Sufiyan, Rizwan Suliankatchi Abdulkader, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Amir Taherkhani, Mohamad-Hani Temsah, Kavumpurathu Raman Thankappan, Marcos Roberto Tovani-Palone, Eugenio Traini, Saif Ullah, Bhaskaran Unnikrishnan, Era Upadhyay, Sahel Valadan Tahbaz, Santosh Varughese, Francesco S Violante, Bay Vo, Giang Thu Vu, Yasir Waheed, Yuan-Pang Wang, Catherine A Welgan, Andrea Werdecker, Seyed Hossein Yahyazadeh Jabbari, Sanni Yaya, Vahid Yazdi-Feyzabadi, Mekdes Tigistu Yilma, Naohiro Yonemoto, Mustafa Z Younis, Taraneh Yousefinezhadi, Chuanhua Yu, Yong Yu, Sojib Bin Zaman, Yunquan Zhang, Zhi-Jiang Zhang, Michael Brauer, Simon I Hay, and Robert C Reiner, Jr
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels. Methods: We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km × 5 km resolution in 98 LMICs based on 2·1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution. Findings: Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205 000 (95% uncertainty interval 147 000–257 000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution. Interpretation: Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution. Funding: Bill & Melinda Gates Foundation.
Published: 2022
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2. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019

Author: Emma Nichols, Jaimie D Steinmetz, Stein Emil Vollset, Kai Fukutaki, Julian Chalek, Foad Abd-Allah, Amir Abdoli, Ahmed Abualhasan, Eman Abu-Gharbieh, Tayyaba Tayyaba Akram, Hanadi Al Hamad, Fares Alahdab, Fahad Mashhour Alanezi, Vahid Alipour, Sami Almustanyir, Hubert Amu, Iman Ansari, Jalal Arabloo, Tahira Ashraf, Thomas Astell-Burt, Getinet Ayano, Jose L Ayuso-Mateos, Atif Amin Baig, Anthony Barnett, Amadou Barrow, Bernhard T Baune, Yannick Béjot, Woldesellassie M Mequanint Bezabhe, Yihienew Mequanint Bezabih, Akshaya Srikanth Bhagavathula, Sonu Bhaskar, Krittika Bhattacharyya, Ali Bijani, Atanu Biswas, Srinivasa Rao Bolla, Archith Boloor, Carol Brayne, Hermann Brenner, Katrin Burkart, Richard A Burns, Luis Alberto Cámera, Chao Cao, Felix Carvalho, Luis F S Castro-de-Araujo, Ferrán Catalá-López, Ester Cerin, Prachi P Chavan, Nicolas Cherbuin, Dinh-Toi Chu, Vera Marisa Costa, Rosa A S Couto, Omid Dadras, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Vanessa De la Cruz-Góngora, Deepak Dhamnetiya, Diana Dias da Silva, Daniel Diaz, Abdel Douiri, David Edvardsson, Michael Ekholuenetale, Iman El Sayed, Shaimaa I El-Jaafary, Khalil Eskandari, Sharareh Eskandarieh, Saman Esmaeilnejad, Jawad Fares, Andre Faro, Umar Farooque, Valery L Feigin, Xiaoqi Feng, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Pietro Ferrara, Irina Filip, Howard Fillit, Florian Fischer, Shilpa Gaidhane, Lucia Galluzzo, Ahmad Ghashghaee, Nermin Ghith, Alessandro Gialluisi, Syed Amir Gilani, Ionela-Roxana Glavan, Elena V Gnedovskaya, Mahaveer Golechha, Rajeev Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Mohammad Rifat Haider, Brian J Hall, Samer Hamidi, Asif Hanif, Graeme J Hankey, Shafiul Haque, Risky Kusuma Hartono, Ahmed I Hasaballah, M Tasdik Hasan, Amr Hassan, Simon I Hay, Khezar Hayat, Mohamed I Hegazy, Golnaz Heidari, Reza Heidari-Soureshjani, Claudiu Herteliu, Mowafa Househ, Rabia Hussain, Bing-Fang Hwang, Licia Iacoviello, Ivo Iavicoli, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Seyed Sina Naghibi Irvani, Hiroyasu Iso, Masao Iwagami, Roxana Jabbarinejad, Louis Jacob, Vardhmaan Jain, Sathish Kumar Jayapal, Ranil Jayawardena, Ravi Prakash Jha, Jost B Jonas, Nitin Joseph, Rizwan Kalani, Amit Kandel, Himal Kandel, André Karch, Ayele Semachew Kasa, Gizat M Kassie, Pedram Keshavarz, Moien AB Khan, Mahalaqua Nazli Khatib, Tawfik Ahmed Muthafer Khoja, Jagdish Khubchandani, Min Seo Kim, Yun Jin Kim, Adnan Kisa, Sezer Kisa, Mika Kivimäki, Walter J Koroshetz, Ai Koyanagi, G Anil Kumar, Manasi Kumar, Hassan Mehmood Lak, Matilde Leonardi, Bingyu Li, Stephen S Lim, Xuefeng Liu, Yuewei Liu, Giancarlo Logroscino, Stefan Lorkowski, Giancarlo Lucchetti, Ricardo Lutzky Saute, Francesca Giulia Magnani, Ahmad Azam Malik, João Massano, Man Mohan Mehndiratta, Ritesh G Menezes, Atte Meretoja, Bahram Mohajer, Norlinah Mohamed Ibrahim, Yousef Mohammad, Arif Mohammed, Ali H Mokdad, Stefania Mondello, Mohammad Ali Ali Moni, Md Moniruzzaman, Tilahun Belete Mossie, Gabriele Nagel, Muhammad Naveed, Vinod C Nayak, Sandhya Neupane Kandel, Trang Huyen Nguyen, Bogdan Oancea, Nikita Otstavnov, Stanislav S Otstavnov, Mayowa O Owolabi, Songhomitra Panda-Jonas, Fatemeh Pashazadeh Kan, Maja Pasovic, Urvish K Patel, Mona Pathak, Mario F P Peres, Arokiasamy Perianayagam, Carrie B Peterson, Michael R Phillips, Marina Pinheiro, Michael A Piradov, Constance Dimity Pond, Michele H Potashman, Faheem Hyder Pottoo, Sergio I Prada, Amir Radfar, Alberto Raggi, Fakher Rahim, Mosiur Rahman, Pradhum Ram, Priyanga Ranasinghe, David Laith Rawaf, Salman Rawaf, Nima Rezaei, Aziz Rezapour, Stephen R Robinson, Michele Romoli, Gholamreza Roshandel, Ramesh Sahathevan, Amirhossein Sahebkar, Mohammad Ali Sahraian, Brijesh Sathian, Davide Sattin, Monika Sawhney, Mete Saylan, Silvia Schiavolin, Allen Seylani, Feng Sha, Masood Ali Shaikh, KS Shaji, Mohammed Shannawaz, Jeevan K Shetty, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Diego Augusto Santos Silva, João Pedro Silva, Renata Silva, Jasvinder A Singh, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Amanda E Smith, Sergey Soshnikov, Emma Elizabeth Spurlock, Dan J Stein, Jing Sun, Rafael Tabarés-Seisdedos, Bhaskar Thakur, Binod Timalsina, Marcos Roberto Tovani-Palone, Bach Xuan Tran, Gebiyaw Wudie Tsegaye, Sahel Valadan Tahbaz, Pascual R Valdez, Narayanaswamy Venketasubramanian, Vasily Vlassov, Giang Thu Vu, Linh Gia Vu, Yuan-Pang Wang, Anders Wimo, Andrea Sylvia Winkler, Lalit Yadav, Seyed Hossein Yahyazadeh Jabbari, Kazumasa Yamagishi, Lin Yang, Yuichiro Yano, Naohiro Yonemoto, Chuanhua Yu, Ismaeel Yunusa, Siddhesh Zadey, Mikhail Sergeevich Zastrozhin, Anasthasia Zastrozhina, Zhi-Jiang Zhang, Christopher J L Murray, and Theo Vos
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for public health planning and resource prioritisation. This study aimed to improve on previous forecasts of dementia prevalence by producing country-level estimates and incorporating information on selected risk factors. Methods: We forecasted the prevalence of dementia attributable to the three dementia risk factors included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 (high body-mass index, high fasting plasma glucose, and smoking) from 2019 to 2050, using relative risks and forecasted risk factor prevalence to predict GBD risk-attributable prevalence in 2050 globally and by world region and country. Using linear regression models with education included as an additional predictor, we then forecasted the prevalence of dementia not attributable to GBD risks. To assess the relative contribution of future trends in GBD risk factors, education, population growth, and population ageing, we did a decomposition analysis. Findings: We estimated that the number of people with dementia would increase from 57·4 (95% uncertainty interval 50·4–65·1) million cases globally in 2019 to 152·8 (130·8–175·9) million cases in 2050. Despite large increases in the projected number of people living with dementia, age-standardised both-sex prevalence remained stable between 2019 and 2050 (global percentage change of 0·1% [–7·5 to 10·8]). We estimated that there were more women with dementia than men with dementia globally in 2019 (female-to-male ratio of 1·69 [1·64–1·73]), and we expect this pattern to continue to 2050 (female-to-male ratio of 1·67 [1·52–1·85]). There was geographical heterogeneity in the projected increases across countries and regions, with the smallest percentage changes in the number of projected dementia cases in high-income Asia Pacific (53% [41–67]) and western Europe (74% [58–90]), and the largest in north Africa and the Middle East (367% [329–403]) and eastern sub-Saharan Africa (357% [323–395]). Projected increases in cases could largely be attributed to population growth and population ageing, although their relative importance varied by world region, with population growth contributing most to the increases in sub-Saharan Africa and population ageing contributing most to the increases in east Asia. Interpretation: Growth in the number of individuals living with dementia underscores the need for public health planning efforts and policy to address the needs of this group. Country-level estimates can be used to inform national planning efforts and decisions. Multifaceted approaches, including scaling up interventions to address modifiable risk factors and investing in research on biological mechanisms, will be key in addressing the expected increases in the number of individuals affected by dementia. Funding: Bill & Melinda Gates Foundation and Gates Ventures.
Published: 2022
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3. Grand Challenges in global eye health: a global prioritisation process using Delphi method

Author: Jacqueline Ramke, PhD, Jennifer R Evans, PhD, Esmael Habtamu, PhD, Nyawira Mwangi, PhD, Juan Carlos Silva, MD, Bonnielin K Swenor, PhD, Nathan Congdon, ProfMD, Hannah B Faal, ProfFRCOphth, Allen Foster, ProfFRCOphth, David S Friedman, ProfPhD, Stephen Gichuhi, PhD, Jost B Jonas, ProfPhD, Peng T Khaw, ProfPhD, Fatima Kyari, PhD, Gudlavalleti V S Murthy, ProfMD, Ningli Wang, ProfPhD, Tien Y Wong, ProfMD, Richard Wormald, MSc, Mayinuer Yusufu, MTI, Hugh Taylor, FRANZCO, Serge Resnikoff, ProfPhD, Sheila K West, ProfPhD, Matthew J Burton, ProfPhD, Ada Aghaji, Adeyemi T Adewole, Adrienne Csutak, Ahmad Shah Salam, Ala Paduca, Alain M Bron, Alastair K Denniston, Alberto Lazo Legua, Aldiana Halim, Alemayehu Woldeyes Tefera, Alice Mwangi, Alicia J Jenkins, Amanda Davis, Amel Meddeb-Ouertani, Amina H Wali, Ana G Palis, Ana Bastos de Carvalho, Anagha Joshi, Andreas J Kreis, Andreas Mueller, Andrew Bastawrous, Andrew Cooper, Andrew F Smith, Andrzej Grzybowski, Anitha Arvind, Anne M Karanu, Anne O Orlina, Anthea Burnett, Aryati Yashadhana, Asela P Abeydeera, Aselia Abdurakhmanova, Ashik Mohamed, Ashish Bacchav, Ashlie Bernhisel, Aubrey Walton Webson, Augusto Azuara-Blanco, Ava Hossain, Bayazit Ilhan, Bella Assumpta Lucienne, Benoit Tousignant, Bindiganavale R Shamanna, Boateng Wiafe, Brigitte Mueller, Cagatay Caglar, Caleb Mpyet, Carl H Abraham, Carol Y Cheung, Cassandra L Thiel, Catherine L Jan, Chike Emedike, Chimgee Chuluunkhuu, Chinomso Chinyere, Christin Henein, Clare E Gilbert, Covadonga Bascaran, Cristina Elena Nitulescu, Daksha Patel, Damodar Bachani, Daniel Kiage, Daniel Etya'ale, David Dahdal, Dawn Woo Lawson, Denise Godin, Dennis G Nkanga, Dennis M Ondeyo, Donna O'Brien, Dorothy M Mutie, Ebtisam S K Alalawi, Eduardo Mayorga, Effendy Bin Hashim, Elham Ashrafi, Elizabeth Andrew Kishiki, Elizabeth Kurian, Fabrizio D'Esposito, Faith Masila, Fernando Yaacov Pena, Fortunat Büsch, Fotis Topouzis, Francesco Bandello, Funmilayo J Oyediji, Gabriele Thumann, Gamal Ezz Elarab, Gatera Fiston Kitema, Gerhard Schlenther, Gertrude Oforiwa Fefoame, Gillian M Cochrane, Guna Laganovska, Haroon R Awan, Harris M Ansari, Heiko Philippin, Helen Burn, Helen Dimaras, Helena P Filipe, Henrietta I Monye, Himal Kandel, Hoby Lalaina Randrianarisoa, Iain Jones, Ian E Murdoch, Ido Didi Fabian, Imran A Khan, Indra P Sharma, Islam Elbeih, Islay Mactaggart, J Carlos Pastor, Jan E E Keunen, Jane A Ohuma, Jason Pithuwa Nirwoth, Jaouad Hammou, Jayme R Vianna, Jean-eudes Biao, Jennifer M Burr, Jeremy D Keenan, Jess Blijkers, Joanna M Black, Joao Barbosa Breda, Joao M Furtado, John C Buchan, John G Lawrenson, John H Kempen, Joshua R Ehrlich, Judith Stern, Justine H Zhang, Kadircan H Keskinbora, Karin M Knoll, Karl Blanchet, Katrina L Schmid, Koichi Ono, Kolawole Ogundimu, Komi Balo, Kussome Paulin Somda, Kwame Yeboah, Kwesi N Amissah-Arthur, Leone Nasehi, Lene Øverland, Lingam Vijaya, Lisa Keay, Lisa M Hamm, Lizette Mowatt, Lloyd C M Harrison-Williams, Lucia Silva, Luigi Bilotto, Manfred Mörchen, Mansur Rabiu, Marcia Zondervan, Margarida Chagunda, Maria Teresa Sandinha, Mariano Yee Melgar, Marisela Salas Vargas, Mark D Daniell, Marzieh Katibeh, Matt Broom, Megan E Collins, Mehmet Numan Alp, Michael A Kwarteng, Michael Belkin, Michael Gichangi, Michelle Sylvanowicz, Min Wu, Miriam R Cano, Mohammad Shalaby, Mona Duggal, Moncef Khairallah, Muhammed Batur, Mukharram M Bikbov, Muralidhar Ramappa, Nagaraju Pamarathi, Naira Khachatryan, Nasiru Muhammad, Neil Kennedy, Neil Murray, Nicholas A V Beare, Nick Astbury, Nicole A Carnt, Nigel A St Rose, Nigel H Barker, Niranjan K Pehere, Nkechinyere J Uche, Noemi Lois, Oluwaseun O Awe, Oscar J Mujica, Oteri E Okolo, Padmaja Kumari Rani, Paisan Ruamviboonsuk, Papa Amadou Ndiaye, Parami Dhakhwa, Pavel Rozsival, Pearl K Mbulawa, Pearse A Keane, Pete R Jones, Peter Holland, Phanindra Babu Nukella, Philip I Burgess, Pinar Aydin O'Dwyer, Prabhath Piyasena, Pradeep Bastola, Priya Morjaria, Qais Nasimee, Raizza A T Rambacal, Rajdeep Das, Rajiv B Khandekar, Rajvardhan Azad, Ramona Bashshur, Raúl A R C Sousa, Rebecca Oenga, Reeta Gurung, Robert Geneau, Robert J Jacobs, Robert P Finger, Robyn H Guymer, Rodica Sevciuc, Rohit C Khanna, Ronnie George, Ronnie Graham, Ryo Kawasaki, S May Ho, Sailesh Kumar Mishra, Sandeep Buttan, Sandra S Block, Sandra Talero, Sangchul Yoon, Sanil Joseph, Sare Safi, Sarity Dodson, Sergio R Munoz, Seydou Bakayoko, Seyed Farzad Mohammadi, Shabir Ahmad Muez, Shahina Pardhan, Shelley Hopkins, Shwu-Jiuan Sheu, Sidi Mohamed Coulibaly, Silvana A Schellini, Simon Arunga, Simon R Bush, Sobha Sivaprasad, Solange R Salomao, Srinivas Marmamula, Stella N Onwubiko, Stuti L Misra, Subeesh Kuyyadiyil, Sucheta Kulkarni, Sudarshan khanal, Sumrana Yasmin, Suzana Nikolic Pavljasevic, Suzanne S Gilbert, Tasanee Braithwaite, Tatiana Ghidirimschi, Thulasiraj Ravilla, Timothy R Fricke, Tiziana Cogliati, Tsehaynesh Kassa, Tunde Peto, Ute Dibb, Van C Lansingh, Victor H Hu, Victoria M Sheffield, Wanjiku Mathenge, William H Dean, Winifred Nolan, Yoshimune Hiratsuka, Yousaf Jamal Mahsood, and Yuddha Sapkota
Subjects: Geriatrics, RC952-954.6, Medicine
Abstract: Summary: Background: We undertook a Grand Challenges in Global Eye Health prioritisation exercise to identify the key issues that must be addressed to improve eye health in the context of an ageing population, to eliminate persistent inequities in health-care access, and to mitigate widespread resource limitations. Methods: Drawing on methods used in previous Grand Challenges studies, we used a multi-step recruitment strategy to assemble a diverse panel of individuals from a range of disciplines relevant to global eye health from all regions globally to participate in a three-round, online, Delphi-like, prioritisation process to nominate and rank challenges in global eye health. Through this process, we developed both global and regional priority lists. Findings: Between Sept 1 and Dec 12, 2019, 470 individuals complete round 1 of the process, of whom 336 completed all three rounds (round 2 between Feb 26 and March 18, 2020, and round 3 between April 2 and April 25, 2020) 156 (46%) of 336 were women, 180 (54%) were men. The proportion of participants who worked in each region ranged from 104 (31%) in sub-Saharan Africa to 21 (6%) in central Europe, eastern Europe, and in central Asia. Of 85 unique challenges identified after round 1, 16 challenges were prioritised at the global level; six focused on detection and treatment of conditions (cataract, refractive error, glaucoma, diabetic retinopathy, services for children and screening for early detection), two focused on addressing shortages in human resource capacity, five on other health service and policy factors (including strengthening policies, integration, health information systems, and budget allocation), and three on improving access to care and promoting equity. Interpretation: This list of Grand Challenges serves as a starting point for immediate action by funders to guide investment in research and innovation in eye health. It challenges researchers, clinicians, and policy makers to build collaborations to address specific challenges. Funding: The Queen Elizabeth Diamond Jubilee Trust, Moorfields Eye Charity, National Institute for Health Research Moorfields Biomedical Research Centre, Wellcome Trust, Sightsavers, The Fred Hollows Foundation, The Seva Foundation, British Council for the Prevention of Blindness, and Christian Blind Mission. Translations: For the French, Spanish, Chinese, Portuguese, Arabic and Persian translations of the abstract see Supplementary Materials section.
Published: 2022
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4. Retinal photograph-based deep learning algorithms for myopia and a blockchain platform to facilitate artificial intelligence medical research: a retrospective multicohort study

Author: Tien-En Tan, FRCOphth, Ayesha Anees, MSc, Cheng Chen, MSc, Shaohua Li, PhD, Xinxing Xu, PhD, Zengxiang Li, PhD, Zhe Xiao, PhD, Yechao Yang, BSc, Xiaofeng Lei, MSc, Marcus Ang, FRCS (Ed), Audrey Chia, FRANZCO, Shu Yen Lee, FRCS (Ed), Edmund Yick Mun Wong, FRCS (Ed), Ian Yew San Yeo, ProfFRCS (Ed), Yee Ling Wong, PhD, Quan V Hoang, MD, Ya Xing Wang, MD, Mukharram M Bikbov, MD, Vinay Nangia, MD, Jost B Jonas, ProfMD, Yen-Po Chen, MD, Wei-Chi Wu, ProfMD, Kyoko Ohno-Matsui, ProfMD, Tyler Hyungtaek Rim, MD, Yih-Chung Tham, PhD, Rick Siow Mong Goh, PhD, Haotian Lin, ProfMD, Hanruo Liu, MD, Ningli Wang, ProfMD, Weihong Yu, ProfMD, Donald Tiang Hwee Tan, ProfFRCS (Ed), Leopold Schmetterer, ProfPhD, Ching-Yu Cheng, ProfMD, Youxin Chen, ProfMD, Chee Wai Wong, MBBS, Gemmy Chui Ming Cheung, ProfFRCOphth, Seang-Mei Saw, ProfPhD, Tien Yin Wong, ProfMD, Yong Liu, PhD, and Daniel Shu Wei Ting, MD
Subjects: Computer applications to medicine. Medical informatics, R858-859.7
Abstract: Summary: Background: By 2050, almost 5 billion people globally are projected to have myopia, of whom 20% are likely to have high myopia with clinically significant risk of sight-threatening complications such as myopic macular degeneration. These are diagnoses that typically require specialist assessment or measurement with multiple unconnected pieces of equipment. Artificial intelligence (AI) approaches might be effective for risk stratification and to identify individuals at highest risk of visual loss. However, unresolved challenges for AI medical studies remain, including paucity of transparency, auditability, and traceability. Methods: In this retrospective multicohort study, we developed and tested retinal photograph-based deep learning algorithms for detection of myopic macular degeneration and high myopia, using a total of 226 686 retinal images. First we trained and internally validated the algorithms on datasets from Singapore, and then externally tested them on datasets from China, Taiwan, India, Russia, and the UK. We also compared the performance of the deep learning algorithms against six human experts in the grading of a randomly selected dataset of 400 images from the external datasets. As proof of concept, we used a blockchain-based AI platform to demonstrate the real-world application of secure data transfer, model transfer, and model testing across three sites in Singapore and China. Findings: The deep learning algorithms showed robust diagnostic performance with areas under the receiver operating characteristic curves [AUC] of 0·969 (95% CI 0·959–0·977) or higher for myopic macular degeneration and 0·913 (0·906–0·920) or higher for high myopia across the external testing datasets with available data. In the randomly selected dataset, the deep learning algorithms outperformed all six expert graders in detection of each condition (AUC of 0·978 [0·957–0·994] for myopic macular degeneration and 0·973 [0·941–0·995] for high myopia). We also successfully used blockchain technology for data transfer, model transfer, and model testing between sites and across two countries. Interpretation: Deep learning algorithms can be effective tools for risk stratification and screening of myopic macular degeneration and high myopia among the large global population with myopia. The blockchain platform developed here could potentially serve as a trusted platform for performance testing of future AI models in medicine. Funding: None.
Published: 2021
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5. Prediction of systemic biomarkers from retinal photographs: development and validation of deep-learning algorithms

Author: Tyler Hyungtaek Rim, MD, Geunyoung Lee, BS, Youngnam Kim, MSc, Yih-Chung Tham, PhD, Chan Joo Lee, MD, Su Jung Baik, MD, Young Ah Kim, PhD, Marco Yu, PhD, Mihir Deshmukh, MSc, Byoung Kwon Lee, ProfMD, Sungha Park, ProfMD, Hyeon Chang Kim, ProfMD, Charumathi Sabayanagam, PhD, Daniel S W Ting, MD, Ya Xing Wang, MD, Jost B Jonas, ProfMD, Sung Soo Kim, MD, Tien Yin Wong, ProfMD, and Ching-Yu Cheng, ProfMD
Subjects: Computer applications to medicine. Medical informatics, R858-859.7
Abstract: Summary: Background: The application of deep learning to retinal photographs has yielded promising results in predicting age, sex, blood pressure, and haematological parameters. However, the broader applicability of retinal photograph-based deep learning for predicting other systemic biomarkers and the generalisability of this approach to various populations remains unexplored. Methods: With use of 236 257 retinal photographs from seven diverse Asian and European cohorts (two health screening centres in South Korea, the Beijing Eye Study, three cohorts in the Singapore Epidemiology of Eye Diseases study, and the UK Biobank), we evaluated the capacities of 47 deep-learning algorithms to predict 47 systemic biomarkers as outcome variables, including demographic factors (age and sex); body composition measurements; blood pressure; haematological parameters; lipid profiles; biochemical measures; biomarkers related to liver function, thyroid function, kidney function, and inflammation; and diabetes. The standard neural network architecture of VGG16 was adopted for model development. Findings: In addition to previously reported systemic biomarkers, we showed quantification of body composition indices (muscle mass, height, and bodyweight) and creatinine from retinal photographs. Body muscle mass could be predicted with an R2 of 0·52 (95% CI 0·51–0·53) in the internal test set, and of 0·33 (0·30–0·35) in one external test set with muscle mass measurement available. The R2 value for the prediction of height was 0·42 (0·40–0·43), of bodyweight was 0·36 (0·34–0·37), and of creatinine was 0·38 (0·37–0·40) in the internal test set. However, the performances were poorer in external test sets (with the lowest performance in the European cohort), with R2 values ranging between 0·08 and 0·28 for height, 0·04 and 0·19 for bodyweight, and 0·01 and 0·26 for creatinine. Of the 47 systemic biomarkers, 37 could not be predicted well from retinal photographs via deep learning (R2≤0·14 across all external test sets). Interpretation: Our work provides new insights into the potential use of retinal photographs to predict systemic biomarkers, including body composition indices and serum creatinine, using deep learning in populations with a similar ethnic background. Further evaluations are warranted to validate these findings and evaluate the clinical utility of these algorithms. Funding: Agency for Science, Technology, and Research and National Medical Research Council, Singapore; Korea Institute for Advancement of Technology.
Published: 2020
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6. Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000–17

Author: Kirsten E Wiens, Paulina A Lindstedt, Brigette F Blacker, Kimberly B Johnson, Mathew M Baumann, Lauren E Schaeffer, Hedayat Abbastabar, Sr, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R M Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Dilaram Acharya, Maryam Adabi, Abdu A Adamu, Oladimeji M Adebayo, Rufus Adesoji Adedoyin, Sr, Victor Adekanmbi, Olatunji O Adetokunboh, Sr, Beyene Meressa Adhena, Mohsen Afarideh, Sohail Ahmad, Keivan Ahmadi, Anwar E Ahmed, Muktar Beshir Ahmed, Rushdia Ahmed, Temesgen Yihunie Akalu, Fares Alahdab, Ziyad Al-Aly, Noore Alam, Sr, Samiah Alam, Genet Melak Alamene, Turki M Alanzi, Jacqueline Elizabeth Alcalde-Rabanal, Beriwan Abdulqadir Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Sr, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J Alvis-Zakzuk, Saeed Amini, Sr, Arianna Maever L Amit, Sr, Catalina Liliana Andrei, Sr, Mina Anjomshoa, Amir Anoushiravani, Sr, Fereshteh Ansari, Carl Abelardo T Antonio, Benny Antony, Ernoiz Antriyandarti, Jalal Arabloo, Hany Mohamed Amin Aref, Sr, Olatunde Aremu, Bahram Armoon, Amit Arora, Sr, Krishna K Aryal, Afsaneh Arzani, Mehran Asadi-Aliabadi, Hagos Tasew Atalay, Seyyed Shamsadin Athari, Sr, Seyyede Masoume Athari, Sachin R Atre, Marcel Ausloos, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Martin Amogre Ayanore, Sr, Yared Asmare Aynalem IV, Samad Azari, Peter S Azzopardi, Ebrahim Babaee, Tesleem Kayode Babalola, Alaa Badawi, Sr, Mohan Bairwa, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Ayele Geleto Bali, Maciej Banach, Sr, Joseph Adel Mattar Banoub, Sr, Aleksandra Barac, Till Winfried Bärnighausen, Huda Basaleem, Sanjay Basu, Vo Dinh Bay, Mohsen Bayati, Estifanos Baye, Neeraj Bedi, Mahya Mahya Beheshti Beheshti, Masoud Behzadifar, Meysam Behzadifar, Bayu Begashaw Bekele, Yaschilal Muche Belayneh, Michellr L Bell, Sr, Derrick A Bennett, Sr, Dessalegn Ajema Berbada, Robert S Bernstein, Anusha Ganapati Bhat, Sr, Krittika Bhattacharyya, Sr, Suraj Bhattarai, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Ali Bijani, Boris Bikbov, Binyam Minuye Birihane IV, Raaj Kishore Biswas, Somayeh Bohlouli, Hunduma Amensisa Amensisa Bojia I, Soufiane Boufous, Oliver J Brady, Nicola Luigi Bragazzi, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Gabrielle B Britton, Sharath Burugina Nagaraja, Sr, Reinhard Busse, Sr, Zahid A Butt, Luis LA Alberto Cámera, Sr, Ismael R Campos-Nonato, Sr, Jorge Cano, Josip Car, Rosario Cárdenas, Felix Carvalho, Sr, Carlos A Castañeda-Orjuela, Sr, Franz Castro, Wagaye Fentahun Chanie, Sr, Pranab Chatterjee, Vijay Kumar Chattu, Tesfaye Yitna Yitna Chichiabellu, Jr, Ken Lee Chin, Sr, Devasahayam J Christopher, Dinh-Toi Chu, Natalie Maria Cormier, Vera Marisa Costa, Carlos Culquichicon, Matiwos Soboka Daba, Giovanni Damiani, Sr, Lalit Dandona, Rakhi Dandona, Anh Kim Dang, Aso Mohammad Darwesh, Amira Hamed Darwish, Ahmad Daryani, Sr, Jai K Das, Rajat Das Gupta, Aditya Prasad Dash, Gail Davey, Claudio Alberto Dávila-Cervantes, Adrian C Davis, Sr, Dragos Virgil Davitoiu, Fernando Pio De la Hoz, Asmamaw Bizuneh Demis, Dereje Bayissa Demissie, Getu Debalkie Demissie, Gebre Teklemariam Demoz, Sr, Edgar Denova-Gutiérrez, Sr, Kebede Deribe, Sr, Assefa Desalew, Aniruddha Deshpande, Samath Dhamminda Dharmaratne, Preeti Dhillon, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Sr, Isaac Oluwafemi Dipeolu, Shirin Djalalinia, Kerrie E Doyle, Eleonora Dubljanin, Bereket Duko, Andre Rodrigues Duraes, Mohammad Ebrahimi Kalan, Hisham Atan Edinur, Sr, Andem Effiong, Sr, Aziz Eftekhari, Nevine El Nahas, Iman El Sayed, Maysaa El Sayed Zaki, Maha El Tantawi, Teshome Bekele Elema I, Hala Rashad Elhabashy, Sr, Shaimaa I El-Jaafary, Hajer Elkout, Aisha Elsharkawy, Iqbal RF Elyazar, Aklilu Endalamaw, Daniel Adane Endalew, Sr, Sharareh Eskandarieh, Alireza Esteghamati, Sadaf Esteghamati, Sr, Arash Etemadi, Oluchi Ezekannagha, Mohammad Fareed, Roghiyeh Faridnia, Farshad Farzadfar, Mehdi Fazlzadeh, Valery L Feigin, Sr, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Nataliya A Foigt, Morenike Oluwatoyin Folayan, Sr, Masoud Foroutan, Richard Charles Franklin, Takeshi Fukumoto, Mohamed M Gad, Reta Tsegaye Gayesa, Teshome Gebre, Sr, Ketema Bizuwork Gebremedhin, Gebreamlak Gebremedhn Gebremeskel, Sr, Hailay Abrha Gesesew, Kebede Embaye Gezae, Keyghobad Ghadiri, Sr, Ahmad Ghashghaee, Pramesh Raj Ghimire, Sr, Paramjit Singh Gill, Sr, Tiffany K Gill, Themba G G Ginindza, Nelson G M Gomes, Sameer Vali Gopalani, Alessandra C Goulart, Bárbara Niegia Garcia Goulart, Ayman Grada, Mohammed Ibrahim Mohialdeen Gubari, Harish Chander Gugnani, Sr, Davide Guido, Rafael Alves Guimarães, Yuming Guo, Sr, Rajeev Gupta, Nima Hafezi-Nejad, Dessalegn H Haile, Sr, Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Randah R Hamadeh, Samer Hamidi, Demelash Woldeyohannes Handiso, Hamidreza Haririan, Sr, Ninuk Hariyani, Ahmed I Hasaballah, Md Mehedi Hasan, Edris Hasanpoor, Amir Hasanzadeh, Hadi Hassankhani, Hamid Yimam Hassen, Mohamed I Hegazy, Behzad Heibati, Behnam Heidari, Delia Hendrie, Sr, Nathaniel J Henry, Claudiu Herteliu, Fatemeh Heydarpour, Hagos Degefa de Hidru I, Thomas R Hird, Chi Linh Hoang, Enayatollah Homaie Rad, Praveen Hoogar, Mohammad Hoseini, Naznin Hossain, Mostafa Hosseini, Mehdi Hosseinzadeh, Mowafa Househ, Mohamed Hsairi, Sr, Guoqing Hu, Mohammedaman Mama Hussen, Segun Emmanuel Ibitoye, Ehimario U Igumbor, Sr, Olayinka Stephen Ilesanmi, Milena D Ilic, Mohammad Hasan Imani-Nasab, Usman Iqbal, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Chinwe Juliana Iwu, Neda Izadi, Sr, Anelisa Jaca, Nader Jahanmehr, Mihajlo Jakovljevic, Amir Jalali, Achala Upendra Jayatilleke, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Sr, Jost B Jonas, Jacek Jerzy Jozwiak, Ali Kabir, Zubair Kabir, Sr, Amaha Kahsay, Hamed Kalani, Tanuj Kanchan, Behzad Karami Matin, André Karch, Mohd Anisul Karim, Hamidreza Karimi-Sari, Surendra Karki, Amir Kasaeian, Gebremicheal Gebreslassie Kasahun, Yawukal chane Kasahun, Habtamu Kebebe Kasaye, Gebrehiwot G Kassa, Getachew Mullu Kassa, Gbenga A Kayode, Ali Kazemi Karyani, Mihiretu M Kebede, Peter Njenga Keiyoro, Abraham Getachew Kelbore, Sr, Andre Pascal Kengne, Sr, Daniel Bekele Ketema, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Nauman Khalid, Rovshan Khalilov, Ejaz Ahmad Khan, Sr, Junaid Khan, Md Nuruzzaman Khan I, Muhammad Shahzeb Khan, Khaled Khatab, Sr, Amir M Khater, Mona M Khater, Maryam Khayamzadeh, Mohammad Khazaei, Salman Khazaei, Mohammad Hossein Khosravi, Jagdish Khubchandani, Ali Kiadaliri, Yun Jin Kim, Ruth W Kimokoti, Adnan Kisa, Sezer Kisa, Niranjan Kissoon, Sr, Shivakumar KM Marulasiddaiah M KMShivakumar, Sr, Sonali Kochhar, Tufa Kolola, Sr, Hamidreza Komaki, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Moritz U G Kraemer, Kewal Krishan, Nuworza Kugbey, G Anil Kumar, Manasi Kumar, Sr, Pushpendra Kumar, Vivek Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Sheetal D Lad, Dharmesh Kumar Lal, Felix Lam, Faris Hasan Lami, Sr, Prabhat Lamichhane, Van Charles Lansingh, Savita Lasrado, Avula Laxmaiah, Paul H Lee, Sr, Kate E LeGrand, Mostafa Leili, Tsegaye Lolaso Lenjebo, Cheru Tesema Leshargie, Sr, Aubrey J Levine, Shanshan Li, Sr, Shai Linn, Shiwei Liu, Simin Liu, Rakesh Lodha, Joshua Longbottom, Jaifred Christian F Lopez, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, D R Mahadeshwara Prasad, Phetole Walter Mahasha, Sr, Narayan B Mahotra, Azeem Majeed, Reza Malekzadeh, Sr, Deborah Carvalho Malta, Abdullah A Mamun, Sr, Navid Manafi, Sr, Ana Laura Manda, Narendar Dawani Dawanu Manohar, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Joemer C Maravilla, Gabriel Martinez, Sr, Santi Martini, Francisco Rogerlândio Martins-Melo, Anthony Masaka, Benjamin Ballard Massenburg, Manu Raj Mathur, Benjamin K Mayala, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Man Mohan Mehndiratta, Sr, Kala M Mehta, Tefera C Chane Mekonnen, Gebrekiros Gebremichael Meles, Peter T N Memiah, Ziad A Memish, Sr, Walter Mendoza, Ritesh G Menezes, Seid Tiku Mereta, Tuomo J Meretoja, Sr, Tomislav Mestrovic, Bartosz Miazgowski, Kebadnew Mulatu Mihretie, Sr, Ted R Miller, GK Mini, Erkin M Mirrakhimov, Babak Moazen, Bahram Mohajer, Amjad Mohamadi-Bolbanabad, Dara K Mohammad, Karzan Abdulmuhsin Mohammad, Yousef Mohammad, Naser Mohammad Gholi Mezerji, Roghayeh Mohammadibakhsh, Noushin Mohammadifard, Jemal Abdu Mohammed, Sr, Shafiu Mohammed, Farnam Mohebi, Ali H Mokdad, Mariam Molokhia, Lorenzo Monasta, Yoshan Moodley, Sr, Catrin E Moore, Sr, Ghobad Moradi, Masoud Moradi, Mohammad Moradi-Joo, Maziar Moradi-Lakeh, Paula Moraga, Linda Morales, Ilais Moreno Velásquez, Abbas Mosapour, Simin Mouodi, Seyyed Meysam Mousavi, Miliva Mozaffor I, Kindie Fentahun Muchie, Sr, Getahun Fentaw Mulaw, Sr, Sandra B Munro, Moses K Muriithi, Christopher J L Murray, GVS Murthy, Kamarul Imran Musa, Ghulam Mustafa, Sr, Saravanan Muthupandian, Sr, Ashraf F Nabhan, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Kovin S Naidoo, Gurudatta Naik, Farid Najafi, Vinay Nangia, Sr, Jobert Richie Nansseu, Bruno Ramos Nascimento, Sr, Javad Nazari, Duduzile Edith Ndwandwe, Sr, Ionut Negoi, Sr, Henok Biresaw Netsere Netsere, Sr, Josephine W Ngunjiri, Sr, Cuong Tat Nguyen, Huong Lan Thi Nguyen, Trang Huyen Nguyen, Dabere Nigatu, Solomon Gedlu Nigatu, Dina Nur Anggraini Ningrum, Chukwudi A Nnaji, Marzieh Nojomi, Vuong Minh Nong, Ole F Norheim, Sr, Jean Jacques Noubiap, Soraya Nouraei Motlagh, Bogdan Oancea, Okechukwu Samuel Ogah, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Tinuke O Olagunju, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Obinna E Onwujekwe, Sr, Eyal Oren, Doris V V Ortega-Altamirano, Sr, Osayomwanbo Osarenotor, Frank B Osei, Sr, Mayowa O Owolabi, Mahesh P A, Sr, Jagadish Rao Padubidri, Smita Pakhale, Sangram Kishor Patel, Angel J Paternina-Caicedo, Sr, Ashish Pathak, Sr, George C Patton, Deepak Paudel, Sr, Kebreab Paulos, Sr, Veincent Christian Filipino Pepito, Alexandre Pereira, Norberto Perico, Aslam Pervaiz, Julia Moreira Pescarini, Bakhtiar Piroozi, Meghdad Pirsaheb, Maarten J Postma, Hadi Pourjafar, Farshad Pourmalek, Sr, Akram Pourshams, Hossein Poustchi, Sergio I Prada, Sr, Narayan Prasad, Liliana Preotescu, Hedley Quintana, Navid Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Afarin Rahimi-Movaghar, Vafa Rahimi-Movaghar, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, SHAFIUR Rahman, Fatemeh Rajati, Sr, Saleem Muhammad Rana, Sr, Chhabi Lal Ranabhat, Davide Rasella, David Laith Rawaf, Salman Rawaf, Sr, Lal Rawal, Wasiq Faraz Rawasia, Vishnu Renjith, Andre M N Renzaho, Sr, Serge Resnikoff, Sr, Melese Abate Reta, Negar Rezaei, Mohammad sadegh Rezai, Seyed Mohammad Riahi, Ana Isabel Ribeiro, Jennifer Rickard, Sr, Maria Rios-Blancas, Leonardo Roever, Luca Ronfani, Elias Merdassa Roro, Sr, Jennifer M Ross, Enrico Rubagotti, Salvatore Rubino, Anas M Saad, Yogesh Damodar Sabde, Siamak Sabour, Ehsan Sadeghi, Sr, Yahya Safari, Roya Safari-Faramani, Rajesh Sagar, Amirhossein Sahebkar, Mohammad Ali Sahraian, S Mohammad Sajadi, Mohammad Reza Salahshoor, Nasir Salam, Sr, Payman Salamati, Hosni Salem, Marwa R Rashad Salem I, Yahya Salimi, Hamideh Salimzadeh, Abdallah M Samy, Juan Sanabria, Sr, Milena M Santric-Milicevic, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, Kaushik Sarkar, Sr, Abdur Razzaque Sarker, Nizal Sarrafzadegan I, Benn Sartorius, Brijesh Sathian, Thirunavukkarasu Sathish, Monika Sawhney, Sonia Saxena, Sr, David C Schwebel, Sr, Anbissa Muleta Senbeta IV, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Sr, Hosein Shabaninejad, Azadeh Shafieesabet, Sr, Masood Ali Shaikh, Ali S Shalash, Sr, Seifadin Ahmed Shallo, Mehran Shams-Beyranvand, MohammadBagher Shamsi, Morteza Shamsizadeh, Mohammed Shannawaz, Kiomars Sharafi, Hamid Sharifi, Hatem Samir Shehata, Sr, Aziz Sheikh, B Suresh Kumar Shetty, Sr, Kenji Shibuya, Sr, Wondimeneh Shibabaw Shiferaw, Sr, Desalegn Markos Shifti, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Sr, Reza Shirkoohi, Soraya Siabani, Tariq Jamal Siddiqi, Diego Augusto Santos Silva, Ambrish Singh, Jasvinder A Singh, Narinder Pal Singh, Virendra Singh, Malede Mequanent Sisay, Eirini Skiadaresi, Mohammad Reza Sobhiyeh, Sr, Anton Sokhan, Shahin Soltani, Ranjani Somayaji, Moslem Soofi, Muluken Bekele Sorrie, Sr, Ireneous N Soyiri, Chandrashekhar T Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Sr, Hafiz Ansar Rasul Suleria, Marufa Sultana, Bruno Fokas Sunguya, Bryan L Sykes, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Degena Bahrey Tadesse, Jr, Ingan Ukur Tarigan, Aberash Abay Tasew, Yonatal Mesfin Tefera, Sr, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Berhe Etsay Tesfay I, Fisaha Haile Haile Tesfay, Belay Tessema, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Nihal Thomas, Alemayehu Toma Toma, Sr, Roman Topor-Madry, Marcos Roberto Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Bhaskaran Unnikrishnan, Muhammad Shariq Usman, Sr, Benjamin S Chudi Uzochukwu, Sr, Pascual R Valdez, Santosh Varughese, Sr, Francesco S Violante, Sr, Sebastian Vollmer, Sr, Feleke Gebremeskel W/hawariat, Sr, Yasir Waheed, Mitchell Taylor Wallin, Yafeng Wang, Yuan-Pang Wang, Marcia Weaver, Bedilu Girma Weji, Girmay Teklay Weldesamuel, Catherine A Welgan, Andrea Werdecker, Ronny Westerman, Sr, Taweewat Wiangkham, Charles Shey Wiysonge, Sr, Haileab Fekadu Wolde, Sr, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Sr, Getasew Taddesse Worku, Sr, Ai-Min Wu, Gelin Xu, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Sr, Hiroshi Yatsuya, Alex Yeshaneh, Christopher Sabo Yilgwan, Mekdes Tigistu Yilma, Paul Yip, Sr, Engida Yisma, Naohiro Yonemoto, Sr, Seok-Jun Yoon, Mustafa Z Younis, Mahmoud Yousefifard, Hebat-Allah Salah A Yousof, Chuanhua Yu, Hasan Yusefzadeh, Siddhesh Zadey, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Nejimu Biza Zepro, Taddese Alemu Zerfu, Yunquan Zhang, Xiu-Ju George Zhao, Arash Ziapour, Sanjay Zodpey, Sr, Yves Miel H Zuniga, Simon I Hay, and Robert C Reiner, Jr
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000–17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000–7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910–68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. Funding: Bill & Melinda Gates Foundation.
Published: 2020
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7. Global causes of blindness and distance vision impairment 1990–2020: a systematic review and meta-analysis

Author: Seth R Flaxman, PhD, Rupert R A Bourne, ProfMD, Serge Resnikoff, ProfMD, Peter Ackland, MPhil, Tasanee Braithwaite, MPH, Maria V Cicinelli, MD, Aditi Das, MD, Jost B Jonas, ProfMD, Jill Keeffe, ProfPhD, John H Kempen, MD, Janet Leasher, ProfOD, Hans Limburg, PhD, Kovin Naidoo, PhD, Konrad Pesudovs, ProfPhD, Alex Silvester, MD, Gretchen A Stevens, D.Sc, Nina Tahhan, PhD, Tien Y Wong, ProfPhD, Hugh R Taylor, MD, Rupert Bourne, Peter Ackland, Aries Arditi, Yaniv Barkana, Banu Bozkurt, Tasanee Braithwaite, Alain Bron, Donald Budenz, Feng Cai, Robert Casson, Usha Chakravarthy, Jaewan Choi, Maria Vittoria Cicinelli, Nathan Congdon, Reza Dana, Rakhi Dandona, Lalit Dandona, Aditi Das, Iva Dekaris, Monte Del Monte, Jenny deva, Laura Dreer, Leon Ellwein, Marcela Frazier, Kevin Frick, David Friedman, Joao Furtado, Hua Gao, Gus Gazzard, Ronnie George, Stephen Gichuhi, Victor Gonzalez, Billy Hammond, Mary Elizabeth Hartnett, Minguang He, James Hejtmancik, Flavio Hirai, John Huang, April Ingram, Jonathan Javitt, Jost Jonas, Charlotte Joslin, Jill Keeffe, John Kempen, Moncef Khairallah, Rohit Khanna, Judy Kim, George Lambrou, Van Charles Lansingh, Paolo Lanzetta, Janet Leasher, Jennifer Lim, Hans LIMBURG, Kaweh Mansouri, Anu Mathew, Alan Morse, Beatriz Munoz, David Musch, Kovin Naidoo, Vinay Nangia, Maria Palaiou, Maurizio Battaglia Parodi, Fernando Yaacov Pena, Konrad Pesudovs, Tunde Peto, Harry Quigley, Murugesan Raju, Pradeep Ramulu, Zane Rankin, Serge Resnikoff, Dana Reza, Alan Robin, Luca Rossetti, Jinan Saaddine, Mya Sandar, Janet Serle, Tueng Shen, Rajesh Shetty, Pamela Sieving, Juan Carlos Silva, Alex Silvester, Rita S. Sitorus, Dwight Stambolian, Gretchen Stevens, Hugh Taylor, Jaime Tejedor, James Tielsch, Miltiadis Tsilimbaris, Jan van Meurs, Rohit Varma, Gianni Virgili, Ya Xing Wang, Ning-Li Wang, Sheila West, Peter Wiedemann, Tien Wong, Richard Wormald, and Yingfeng Zheng
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: Contemporary data for causes of vision impairment and blindness form an important basis of recommendations in public health policies. Refreshment of the Global Vision Database with recently published data sources permitted modelling of cause of vision loss data from 1990 to 2015, further disaggregation by cause, and forecasts to 2020. Methods: In this systematic review and meta-analysis, we analysed published and unpublished population-based data for the causes of vision impairment and blindness from 1980 to 2014. We identified population-based studies published before July 8, 2014, by searching online databases with no language restrictions (MEDLINE from Jan 1, 1946, and Embase from Jan 1, 1974, and the WHO Library Database). We fitted a series of regression models to estimate the proportion of moderate or severe vision impairment (defined as presenting visual acuity of 14% of blindness) as causes in the high-income subregions. Blindness and vision impairment at all ages in 2015 due to diabetic retinopathy (odds ratio 2·52 [1·48–3·73]) and cataract (1·21 [1·17–1·25]) were more common among women than among men, whereas blindness and vision impairment due to glaucoma (0·71 [0·57–0·86]) and corneal opacity (0·54 [0·43–0·66]) were more common among men than among women, with no sex difference related to age-related macular degeneration (0·91 [0·70–1·14]). Interpretation: The number of people affected by the common causes of vision loss has increased substantially as the population increases and ages. Preventable vision loss due to cataract (reversible with surgery) and refractive error (reversible with spectacle correction) continue to cause most cases of blindness and moderate or severe vision impairment in adults aged 50 years and older. A large scale-up of eye care provision to cope with the increasing numbers is needed to address avoidable vision loss. Funding: Brien Holden Vision Institute.
Published: 2017
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8. Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis

Author: Prof Rupert R A Bourne, MD, Seth R Flaxman, BA, Tasanee Braithwaite, MPH, Maria V Cicinelli, MD, Aditi Das, MD, Jost B Jonas, MD, Jill Keeffe, PhD, John H Kempen, MD, Janet Leasher, OD, Hans Limburg, PhD, Kovin Naidoo, PhD, Konrad Pesudovs, PhD, Serge Resnikoff, MD, Alex Silvester, MD, Gretchen A Stevens, DSc, Nina Tahhan, PhD, Tien Y Wong, PhD, Hugh R Taylor, MD, Rupert Bourne, Peter Ackland, Aries Arditi, Yaniv Barkana, Banu Bozkurt, TASANEE BRAITHWAITE, Alain Bron, Donald Budenz, Feng Cai, Robert Casson, Usha Chakravarthy, Jaewan Choi, Maria Vittoria Cicinelli, Nathan Congdon, Reza Dana, Rakhi Dandona, Lalit Dandona, Aditi Das, Iva Dekaris, Monte Del Monte, Jenny Deva, Laura Dreer, Leon Ellwein, Marcela Frazier, Kevin Frick, David Friedman, Joao Furtado, Hua Gao, Gus Gazzard, Ronnie George, Stephen Gichuhi, Victor Gonzalez, Billy Hammond, Mary Elizabeth Hartnett, Minguang He, James Hejtmancik, Flavio Hirai, John Huang, April Ingram, Jonathan Javitt, Jost Jonas, Charlotte Joslin, Jill Keeffe, John Kempen, Moncef Khairallah, Rohit Khanna, Judy Kim, George Lambrou, Van Charles Lansingh, Paolo Lanzetta, Janet Leasher, Jennifer Lim, Hans LIMBURG, Kaweh Mansouri, Anu Mathew, Alan Morse, Beatriz Munoz, David Musch, Kovin Naidoo, Vinay Nangia, MARIA PALAIOU, Maurizio Battaglia Parodi, Fernando Yaacov Pena, Konrad Pesudovs, Tunde Peto, Harry Quigley, Murugesan Raju, Pradeep Ramulu, Serge Resnikoff, Alan Robin, Luca Rossetti, Jinan Saaddine, MYA SANDAR, Janet Serle, Tueng Shen, Rajesh Shetty, Pamela Sieving, Juan Carlos Silva, Alex Silvester, Rita S Sitorus, Dwight Stambolian, Gretchen Stevens, Hugh Taylor, Jaime Tejedor, James Tielsch, Miltiadis Tsilimbaris, Jan van Meurs, Rohit Varma, Gianni Virgili, Jimmy Volmink, Ya Xing Wang, Ning-Li Wang, Sheila West, Peter Wiedemann, Tien Wong, Richard Wormald, and Yingfeng Zheng
Subjects: Public aspects of medicine, RA1-1270
Abstract: Background: Global and regional prevalence estimates for blindness and vision impairment are important for the development of public health policies. We aimed to provide global estimates, trends, and projections of global blindness and vision impairment. Methods: We did a systematic review and meta-analysis of population-based datasets relevant to global vision impairment and blindness that were published between 1980 and 2015. We fitted hierarchical models to estimate the prevalence (by age, country, and sex), in 2015, of mild visual impairment (presenting visual acuity worse than 6/12 to 6/18 inclusive), moderate to severe visual impairment (presenting visual acuity worse than 6/18 to 3/60 inclusive), blindness (presenting visual acuity worse than 3/60), and functional presbyopia (defined as presenting near vision worse than N6 or N8 at 40 cm when best-corrected distance visual acuity was better than 6/12). Findings: Globally, of the 7·33 billion people alive in 2015, an estimated 36·0 million (80% uncertainty interval [UI] 12·9–65·4) were blind (crude prevalence 0·48%; 80% UI 0·17–0·87; 56% female), 216·6 million (80% UI 98·5–359·1) people had moderate to severe visual impairment (2·95%, 80% UI 1·34–4·89; 55% female), and 188·5 million (80% UI 64·5–350·2) had mild visual impairment (2·57%, 80% UI 0·88–4·77; 54% female). Functional presbyopia affected an estimated 1094·7 million (80% UI 581·1–1686·5) people aged 35 years and older, with 666·7 million (80% UI 364·9–997·6) being aged 50 years or older. The estimated number of blind people increased by 17·6%, from 30·6 million (80% UI 9·9–57·3) in 1990 to 36·0 million (80% UI 12·9–65·4) in 2015. This change was attributable to three factors, namely an increase because of population growth (38·4%), population ageing after accounting for population growth (34·6%), and reduction in age-specific prevalence (−36·7%). The number of people with moderate and severe visual impairment also increased, from 159·9 million (80% UI 68·3–270·0) in 1990 to 216·6 million (80% UI 98·5–359·1) in 2015. Interpretation: There is an ongoing reduction in the age-standardised prevalence of blindness and visual impairment, yet the growth and ageing of the world's population is causing a substantial increase in number of people affected. These observations, plus a very large contribution from uncorrected presbyopia, highlight the need to scale up vision impairment alleviation efforts at all levels. Funding: Brien Holden Vision Institute.
Published: 2017
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9. Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Author: Prof. Ali H Mokdad, PhD, Mohammad Hossein Forouzanfar, PhD, Farah Daoud, BS, Charbel El Bcheraoui, PhD, Maziar Moradi-Lakeh, MD, Ibrahim Khalil, MD, Ashkan Afshin, DSc, Marwa Tuffaha, MD, Raghid Charara, MD, Ryan M Barber, BS, Joseph Wagner, BS, Kelly Cercy, BS, Hannah Kravitz, BS, Matthew M Coates, BA, Margaret Robinson, BA, Kara Estep, MPA, Caitlyn Steiner, MPH, Sara Jaber, MD, Ali A Mokdad, MD, Kevin F O'Rourke, MFA, Adrienne Chew, ND, Pauline Kim, BA, Mohamed Magdy Abd El Razek, MBBCh, Safa Abdalla, MD, Prof. Foad Abd-Allah, MD, Jerry P Abraham, MD, Laith J Abu-Raddad, PhD, Niveen M E Abu-Rmeileh, PhD, Abdulwahab A Al-Nehmi, MD, Ali S Akanda, PhD, Hanan Al Ahmadi, DrPH, Mazin J Al Khabouri, PhD, Faris H Al Lami, PhD, Zulfa A Al Rayess, ABFM, Deena Alasfoor, MSc, Fadia S AlBuhairan, MD, Saleh F Aldhahri, MD, Suliman Alghnam, PhD, Samia Alhabib, PhD, Nawal Al-Hamad, PhD, Raghib Ali, FRCP, Syed Danish Ali, BA, Mohammad Alkhateeb, RN, Mohammad A AlMazroa, MD, Mahmoud A Alomari, PhD, Rajaa Al-Raddadi, PhD, Ubai Alsharif, MPH, Nihaya Al-Sheyab, PhD, Shirina Alsowaidi, FRCPC, Mohamed Al-Thani, FRCPCH, Khalid A Altirkawi, MD, Azmeraw T Amare, MPH, Heresh Amini, MSPH, Walid Ammar, PhD, Palwasha Anwari, MD, Hamid Asayesh, PhD, Rana Asghar, MD, Prof. Ali M Assabri, PhD, Reza Assadi, PhD, Umar Bacha, PhM, Alaa Badawi, PhD, Talal Bakfalouni, MD, Mohammed O Basulaiman, PhD, Shahrzad Bazargan-Hejazi, PhD, Neeraj Bedi, MD, Amit R Bhakta, MD, Zulfiqar A Bhutta, PhD, Aref A Bin Abdulhak, MD, Soufiane Boufous, PhD, Rupert R A Bourne, FRCOphth, Hadi Danawi, PhD, Jai Das, MBA, Amare Deribew, PhD, Eric L Ding, ScD, Adnan M Durrani, MD, Yousef Elshrek, PhD, Mohamed E Ibrahim, MPhil, Babak Eshrati, PhD, Alireza Esteghamati, MD, Imad A D Faghmous, MPH, Farshad Farzadfar, MD, Andrea B Feigl, ScD, Seyed-Mohammad Fereshtehnejad, MD, Irina Filip, MD, Florian Fischer, MPH, Fortuné G Gankpé, MD, Ibrahim Ginawi, MD, Melkamu Dedefo Gishu, MS, Rahul Gupta, MD, Rami M Habash, MPH, Nima Hafezi-Nejad, MD, Prof. Randah R Hamadeh, DPhil, Hayet Hamdouni, PhD, Samer Hamidi, PhD, Hilda L Harb, MPH, Mohammad Sadegh Hassanvand, PhD, Mohammad T Hedayati, PhD, Pouria Heydarpour, MD, Prof. Mohamed Hsairi, MD, Abdullatif Husseini, PhD, Nader Jahanmehr, PhD, Prof. Vivekanand Jha, DM, Jost B Jonas, MD, Nadim E Karam, MD, Amir Kasaeian, PhD, Nega Assefa Kassa, PhD, Anil Kaul, MD, Prof. Yousef Khader, ScD, Shams Eldin A Khalifa, MSc, Ejaz A Khan, MPH, Gulfaraz Khan, PhD, Tawfik Khoja, FRCP, Ardeshir Khosravi, PhD, Yohannes Kinfu, PhD, Barthelemy Kuate Defo, PhD, Arjun Lakshmana Balaji, MPH, Raimundas Lunevicius, PhD, Prof. Carla Makhlouf Obermeyer, DSc, Reza Malekzadeh, MD, Morteza Mansourian, PhD, Prof. Wagner Marcenes, PhD, Habibolah Masoudi Farid, MD, Alem Mehari, MD, Abla Mehio-Sibai, PhD, Prof. Ziad A Memish, MD, George A Mensah, MD, Karzan A Mohammad, PhD, Prof. Ziad Nahas, MD, Jamal T Nasher, MSc, Haseeb Nawaz, MD, Prof. Chakib Nejjari, PhD, Muhammad Imran Nisar, MSc, Saad B Omer, PhD, Mahboubeh Parsaeian, PhD, Emmanuel K Peprah, PhD, Aslam Pervaiz, MHA, Farshad Pourmalek, PhD, Prof. Dima M Qato, PhD, Mostafa Qorbani, PhD, Amir Radfar, MD, Anwar Rafay, MS, Kazem Rahimi, DM, Vafa Rahimi-Movaghar, MD, Sajjad Ur Rahman, FRCPCH, Rajesh K Rai, MPH, Prof. Saleem M Rana, PhD, Sowmya R Rao, PhD, Amany H Refaat, PhD, Serge Resnikoff, MD, Gholamreza Roshandel, PhD, Georges Saade, MD, Mohammad Y Saeedi, PhD, Mohammad Ali Sahraian, MD, Shadi Saleh, PhD, Lidia Sanchez-Riera, PhD, Maheswar Satpathy, PhD, Sadaf G Sepanlou, MD, Tesfaye Setegn, MPH, Amira Shaheen, PhD, Saeid Shahraz, PhD, Sara Sheikhbahaei, MD, Kawkab Shishani, PhD, Prof. Karen Sliwa, PhD, Mohammad Tavakkoli, MD, Abdullah S Terkawi, MD, Olalekan A Uthman, PhD, Ronny Westerman, PhD, Mustafa Z Younis, DrPH, Prof. Maysaa El Sayed Zaki, PhD, Faiez Zannad, MD, Gregory A Roth, MD, Haidong Wang, PhD, Prof. Mohsen Naghavi, PhD, Prof. Theo Vos, PhD, Abdullah A Al Rabeeah, MBBS, Prof. Alan D Lopez, PhD, and Prof. Christopher J L Murray, DPhil
Subjects: Public aspects of medicine, RA1-1270
Abstract: Background: The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global Burden of Disease Study 2010 (GBD 2010), the region has faced unrest as a result of revolutions, wars, and the so-called Arab uprisings. The objective of this study was to present the burden of diseases, injuries, and risk factors in the eastern Mediterranean region as of 2013. Methods: GBD 2013 includes an annual assessment covering 188 countries from 1990 to 2013. The study covers 306 diseases and injuries, 1233 sequelae, and 79 risk factors. Our GBD 2013 analyses included the addition of new data through updated systematic reviews and through the contribution of unpublished data sources from collaborators, an updated version of modelling software, and several improvements in our methods. In this systematic analysis, we use data from GBD 2013 to analyse the burden of disease and injuries in the eastern Mediterranean region specifically. Findings: The leading cause of death in the region in 2013 was ischaemic heart disease (90·3 deaths per 100 000 people), which increased by 17·2% since 1990. However, diarrhoeal diseases were the leading cause of death in Somalia (186·7 deaths per 100 000 people) in 2013, which decreased by 26·9% since 1990. The leading cause of disability-adjusted life-years (DALYs) was ischaemic heart disease for males and lower respiratory infection for females. High blood pressure was the leading risk factor for DALYs in 2013, with an increase of 83·3% since 1990. Risk factors for DALYs varied by country. In low-income countries, childhood wasting was the leading cause of DALYs in Afghanistan, Somalia, and Yemen, whereas unsafe sex was the leading cause in Djibouti. Non-communicable risk factors were the leading cause of DALYs in high-income and middle-income countries in the region. DALY risk factors varied by age, with child and maternal malnutrition affecting the younger age groups (aged 28 days to 4 years), whereas high bodyweight and systolic blood pressure affected older people (aged 60–80 years). The proportion of DALYs attributed to high body-mass index increased from 3·7% to 7·5% between 1990 and 2013. Burden of mental health problems and drug use increased. Most increases in DALYs, especially from non-communicable diseases, were due to population growth. The crises in Egypt, Yemen, Libya, and Syria have resulted in a reduction in life expectancy; life expectancy in Syria would have been 5 years higher than that recorded for females and 6 years higher for males had the crisis not occurred. Interpretation: Our study shows that the eastern Mediterranean region is going through a crucial health phase. The Arab uprisings and the wars that followed, coupled with ageing and population growth, will have a major impact on the region's health and resources. The region has historically seen improvements in life expectancy and other health indicators, even under stress. However, the current situation will cause deteriorating health conditions for many countries and for many years and will have an impact on the region and the rest of the world. Based on our findings, we call for increased investment in health in the region in addition to reducing the conflicts. Funding: Bill & Melinda Gates Foundation.
Published: 2016
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10. Global prevalence of age-related macular degeneration

Author: Jost B Jonas
Subjects: Public aspects of medicine, RA1-1270
Published: 2014
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11. A new polygenic score for refractive error improves detection of children at risk of high myopia but not the prediction of those at risk of myopic macular degeneration

Author: Rosie Clark, Samantha Sze-Yee Lee, Ran Du, Yining Wang, Sander C.M. Kneepkens, Jason Charng, Yu Huang, Michael L. Hunter, Chen Jiang, J.Willem L. Tideman, Ronald B. Melles, Caroline C.W. Klaver, David A. Mackey, Cathy Williams, Hélène Choquet, Kyoko Ohno-Matsui, Jeremy A. Guggenheim, Joan E. Bailey-Wilson, Paul N. Baird, Veluchamy A. Barathi, Ginevra Biino, Kathryn P. Burdon, Harry Campbell, Li Jia Chen, Ching-Yu Cheng, Emily Y. Chew, Jamie E. Craig, Margaret M. Deangelis, Cécile Delcourt, Xiaohu Ding, Qiao Fan, Maurizio Fossarello, Paul J. Foster, Puya Gharahkhani, Xiaobo Guo, Annechien E.G. Haarman, Toomas Haller, Christopher J. Hammond, Xikun Han, Caroline Hayward, Mingguang He, Alex W. Hewitt, Quan Hoang, Pirro G. Hysi, Adriana I. Iglesias, Robert P. Igo, Sudha K. Iyengar, Jost B. Jonas, Mika Kähönen, Jaakko Kaprio, Anthony P. Khawaja, Barbara E. Klein, Jonathan H. Lass, Kris Lee, Terho Lehtimäki, Deyana Lewis, Qing Li, Shi-Ming Li, Leo-Pekka Lyytikäinen, Stuart MacGregor, Nicholas G. Martin, Akira Meguro, Andres Metspalu, Candace Middlebrooks, Masahiro Miyake, Nobuhisa Mizuki, Anthony Musolf, Stefan Nickels, Konrad Oexle, Chi Pui Pang, Olavi Pärssinen, Andrew D. Paterson, Norbert Pfeiffer, Ozren Polasek, Jugnoo S. Rahi, Olli Raitakari, Igor Rudan, Srujana Sahebjada, Seang-Mei Saw, Claire L. Simpson, Dwight Stambolian, E-Shyong Tai, Milly S. Tedja, J. Willem L. Tideman, Akitaka Tsujikawa, Cornelia M. van Duijn, Virginie J.M. Verhoeven, Veronique Vitart, Ningli Wang, Ya Xing Wang, Juho Wedenoja, Wen Bin Wei, Katie M. Williams, James F. Wilson, Robert Wojciechowski, Jason C.S. Yam, Kenji Yamashiro, Maurice K.H. Yap, Seyhan Yazar, Shea Ping Yip, Terri L. Young, Xiangtian Zhou, Naomi Allen, Tariq Aslam, Denize Atan, Sarah Barman, Jenny Barrett, Paul Bishop, Graeme Black, Catey Bunce, Roxana Carare, Usha Chakravarthy, Michelle Chan, Sharon Chua, Valentina Cipriani, Alexander Day, Parul Desai, Bal Dhillon, Andrew Dick, Alexander Doney, Cathy Egan, Sarah Ennis, Paul Foster, Marcus Fruttiger, John Gallacher, David Garway-Heath, Jane Gibson, Dan Gore, Jeremy Guggenheim, Chris Hammond, Alison Hardcastle, Simon Harding, Ruth Hogg, Pirro Hysi, Pearse A. Keane, Peng Tee Khaw, Anthony Khawaja, Gerassimos Lascaratos, Thomas Littlejohns, Andrew Lotery, Phil Luthert, Tom MacGillivray, Sarah Mackie, Bernadette McGuinness, Gareth McKay, Martin McKibbin, Danny Mitry, Tony Moore, James Morgan, Zaynah Muthy, Eoin O'Sullivan, Chris Owen, Praveen Patel, Euan Paterson, Tunde Peto, Axel Petzold, Nikolas Pontikos, Jugnoo Rahi, Alicja Rudnicka, Jay Self, Panagiotis Sergouniotis, Sobha Sivaprasad, David Steel, Irene Stratton, Nicholas Strouthidis, Cathie Sudlow, Robyn Tapp, Caroline Thaung, Dhanes Thomas, Emanuele Trucco, Adnan Tufail, Stephen Vernon, Ananth Viswanathan, Katie Williams, Jayne Woodside, Max Yates, Jennifer Yip, Yalin Zheng, Neurology, Ophthalmology, APH - Mental Health, APH - Methodology, Amsterdam Neuroscience - Neuroinfection & -inflammation, Epidemiology, Clinical Genetics, and Erasmus MC other
Subjects: All institutes and research themes of the Radboud University Medical Center, General Medicine, General Biochemistry, Genetics and Molecular Biology, Sensory disorders Donders Center for Medical Neuroscience [Radboudumc 12]
Abstract: Contains fulltext : 292919.pdf (Publisher’s version ) (Open Access) BACKGROUND: High myopia (HM), defined as a spherical equivalent refractive error (SER) ≤ -6.00 diopters (D), is a leading cause of sight impairment, through myopic macular degeneration (MMD). We aimed to derive an improved polygenic score (PGS) for predicting children at risk of HM and to test if a PGS is predictive of MMD after accounting for SER. METHODS: The PGS was derived from genome-wide association studies in participants of UK Biobank, CREAM Consortium, and Genetic Epidemiology Research on Adult Health and Aging. MMD severity was quantified by a deep learning algorithm. Prediction of HM was quantified as the area under the receiver operating curve (AUROC). Prediction of severe MMD was assessed by logistic regression. FINDINGS: In independent samples of European, African, South Asian and East Asian ancestry, the PGS explained 19% (95% confidence interval 17-21%), 2% (1-3%), 8% (7-10%) and 6% (3-9%) of the variation in SER, respectively. The AUROC for HM in these samples was 0.78 (0.75-0.81), 0.58 (0.53-0.64), 0.71 (0.69-0.74) and 0.67 (0.62-0.72), respectively. The PGS was not associated with the risk of MMD after accounting for SER: OR = 1.07 (0.92-1.24). INTERPRETATION: Performance of the PGS approached the level required for clinical utility in Europeans but not in other ancestries. A PGS for refractive error was not predictive of MMD risk once SER was accounted for. FUNDING: Supported by the Welsh Government and Fight for Sight (24WG201).
Published: 2023

12. The burden of mental disorders, substance use disorders and self-harm among young people in Europe, 1990–2019: Findings from the Global Burden of Disease Study 2019

Author: Giulio Castelpietra, Ann Kristin Skrindo Knudsen, Emilie E. Agardh, Benedetta Armocida, Massimiliano Beghi, Kim Moesgaard Iburg, Giancarlo Logroscino, Rui Ma, Fabrizio Starace, Nicholas Steel, Giovanni Addolorato, Catalina Liliana Andrei, Tudorel Andrei, Jose L Ayuso-Mateos, Maciej Banach, Till Winfried Bärnighausen, Francesco Barone-Adesi, Akshaya Srikanth Bhagavathula, Felix Carvalho, Márcia Carvalho, Joht Singh Chandan, Vijay Kumar Chattu, Rosa A.S. Couto, Natália Cruz-Martins, Paul I. Dargan, Keshab Deuba, Diana Dias da Silva, Adeniyi Francis Fagbamigbe, Eduarda Fernandes, Pietro Ferrara, Florian Fischer, Peter Andras Gaal, Alessandro Gialluisi, Juanita A. Haagsma, Josep Maria Haro, M. Tasdik Hasan, Syed Shahzad Hasan, Sorin Hostiuc, Licia Iacoviello, Ivo Iavicoli, Elham Jamshidi, Jost B. Jonas, Tamas Joo, Jacek Jerzy Jozwiak, Srinivasa Vittal Katikireddi, Joonas H. Kauppila, Moien A.B. Khan, Adnan Kisa, Sezer Kisa, Mika Kivimäki, Kamrun Nahar Koly, Ai Koyanagi, Manasi Kumar, Tea Lallukka, Berthold Langguth, Caterina Ledda, Paul H. Lee, Ilaria Lega, Christine Linehan, Joana A. Loureiro, Áurea M Madureira-Carvalho, Jose Martinez-Raga, Manu Raj Mathur, John J. McGrath, Enkeleint A. Mechili, Alexios-Fotios A. Mentis, Tomislav Mestrovic, Bartosz Miazgowski, Andreea Mirica, Antonio Mirijello, Babak Moazen, Shafiu Mohammed, Francesk Mulita, Gabriele Nagel, Ionut Negoi, Ruxandra Irina Negoi, Vincent Ebuka Nwatah, Alicia Padron-Monedero, Songhomitra Panda-Jonas, Shahina Pardhan, Maja Pasovic, Jay Patel, Ionela-Roxana Petcu, Marina Pinheiro, Richard Charles G. Pollok, Maarten J. Postma, David Laith Rawaf, Salman Rawaf, Esperanza Romero-Rodríguez, Luca Ronfani, Dominic Sagoe, Francesco Sanmarchi, Michael P Schaub, Nigussie Tadesse Sharew, Rahman Shiri, Farhad Shokraneh, Inga Dora Sigfusdottir, João Pedro Silva, Renata Silva, Bogdan Socea, Miklós Szócska, Rafael Tabarés-Seisdedos, Marco Torrado, Marcos Roberto Tovani-Palone, Tommi Juhani Vasankari, Massimiliano Veroux, Russell M. Viner, Andrea Werdecker, Andrea Sylvia Winkler, Simon I. Hay, Alize J. Ferrari, Mohsen Naghavi, Peter Allebeck, Lorenzo Monasta, Public Health, Castelpietra, G, Knudsen, A, Agardh, E, Armocida, B, Beghi, M, Iburg, K, Logroscino, G, Ma, R, Starace, F, Steel, N, Addolorato, G, Andrei, C, Andrei, T, Ayuso-Mateos, J, Banach, M, Barnighausen, T, Barone-Adesi, F, Bhagavathula, A, Carvalho, F, Carvalho, M, Chandan, J, Chattu, V, Couto, R, Cruz-Martins, N, Dargan, P, Deuba, K, da Silva, D, Fagbamigbe, A, Fernandes, E, Ferrara, P, Fischer, F, Gaal, P, Gialluisi, A, Haagsma, J, Haro, J, Hasan, M, Hasan, S, Hostiuc, S, Iacoviello, L, Iavicoli, I, Jamshidi, E, Jonas, J, Joo, T, Jozwiak, J, Katikireddi, S, Kauppila, J, Khan, M, Kisa, A, Kisa, S, Kivimaki, M, Koly, K, Koyanagi, A, Kumar, M, Lallukka, T, Langguth, B, Ledda, C, Lee, P, Lega, I, Linehan, C, Loureiro, J, Madureira-Carvalho, A, Martinez-Raga, J, Mathur, M, Mcgrath, J, Mechili, E, Mentis, A, Mestrovic, T, Miazgowski, B, Mirica, A, Mirijello, A, Moazen, B, Mohammed, S, Mulita, F, Nagel, G, Negoi, I, Negoi, R, Nwatah, V, Padron-Monedero, A, Panda-Jonas, S, Pardhan, S, Pasovic, M, Patel, J, Petcu, I, Pinheiro, M, Pollok, R, Postma, M, Rawaf, D, Rawaf, S, Romero-Rodriguez, E, Ronfani, L, Sagoe, D, Sanmarchi, F, Schaub, M, Sharew, N, Shiri, R, Shokraneh, F, Sigfusdottir, I, Silva, J, Silva, R, Socea, B, Szocska, M, Tabares-Seisdedos, R, Torrado, M, Tovani-Palone, M, Vasankari, T, Veroux, M, Viner, R, Werdecker, A, Winkler, A, Hay, S, Ferrari, A, Naghavi, M, Allebeck, P, Monasta, L, Castelpietra, G., Knudsen, A. K. S., Agardh, E. E., Armocida, B., Beghi, M., Iburg, K. M., Logroscino, G., Ma, R., Starace, F., Steel, N., Addolorato, G., Andrei, C. L., Andrei, T., Ayuso-Mateos, J. L., Banach, M., Barnighausen, T. W., Barone-Adesi, F., Bhagavathula, A. S., Carvalho, F., Carvalho, M., Chandan, J. S., Chattu, V. K., Couto, R. A. S., Cruz-Martins, N., Dargan, P. I., Deuba, K., da Silva, D. D., Fagbamigbe, A. F., Fernandes, E., Ferrara, P., Fischer, F., Gaal, P. A., Gialluisi, A., Haagsma, J. A., Haro, J. M., Hasan, M. T., Hasan, S. S., Hostiuc, S., Iacoviello, L., Iavicoli, I., Jamshidi, E., Jonas, J. B., Joo, T., Jozwiak, J. J., Katikireddi, S. V., Kauppila, J. H., Khan, M. A. B., Kisa, A., Kisa, S., Kivimaki, M., Koly, K. N., Koyanagi, A., Kumar, M., Lallukka, T., Langguth, B., Ledda, C., Lee, P. H., Lega, I., Linehan, C., Loureiro, J. A., Madureira-Carvalho, A. M., Martinez-Raga, J., Mathur, M. R., Mcgrath, J. J., Mechili, E. A., Mentis, A. -F. A., Mestrovic, T., Miazgowski, B., Mirica, A., Mirijello, A., Moazen, B., Mohammed, S., Mulita, F., Nagel, G., Negoi, I., Negoi, R. I., Nwatah, V. E., Padron-Monedero, A., Panda-Jonas, S., Pardhan, S., Pasovic, M., Patel, J., Petcu, I. -R., Pinheiro, M., Pollok, R. C. G., Postma, M. J., Rawaf, D. L., Rawaf, S., Romero-Rodriguez, E., Ronfani, L., Sagoe, D., Sanmarchi, F., Schaub, M. P., Sharew, N. T., Shiri, R., Shokraneh, F., Sigfusdottir, I. D., Silva, J. P., Silva, R., Socea, B., Szocska, M., Tabares-Seisdedos, R., Torrado, M., Tovani-Palone, M. R., Vasankari, T. J., Veroux, M., Viner, R. M., Werdecker, A., Winkler, A. S., Hay, S. I., Ferrari, A. J., Naghavi, M., Allebeck, P., Monasta, L., Value, Affordability and Sustainability (VALUE), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Microbes in Health and Disease (MHD), University of St Andrews. Population and Behavioural Science Division, University of St Andrews. School of Medicine, Bill & Melinda Gates Foundation, UAM. Departamento de Psiquiatría, Tampere University, Clinical Medicine, Department of Public Health, University of Helsinki, and Helsinki Inequality Initiative (INEQ)
Subjects: Medicina, RJ101, Mental disorders, Substance use, 3121 Internal medicine, Europe, Mental health, Self-harm, Young people, CHILD, RJ101 Child Health. Child health services, SDG 3 - Good Health and Well-being, SYSTEMATIC ANALYSIS, Internal Medicine, Public, Environmental & Occupational Health, RISK, MCC, Science & Technology, Health Policy, DAS, 3142 Public health care science, environmental and occupational health, PREVALENCE, Mental disorder, Health Care Sciences & Services, Oncology, HEALTH, Life Sciences & Biomedicine
Abstract: Artículo escrito por un elevado número de autores, solo se referencian el que aparece en primer lugar, el nombre del grupo de colaboración, si le hubiere, y los autores pertenecientes a la UAM, Background: Mental health is a public health issue for European young people, with great heterogeneity in resource allocation. Representative population-based studies are needed. The Global Burden of Disease (GBD) Study 2019 provides internationally comparable information on trends in the health status of populations and changes in the leading causes of disease burden over time. Methods: Prevalence, incidence, Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) from mental disorders (MDs), substance use disorders (SUDs) and self-harm were estimated for young people aged 10-24 years in 31 European countries. Rates per 100,000 population, percentage changes in 1990-2019, 95% Uncertainty Intervals (UIs), and correlations with Sociodemographic Index (SDI), were estimated. Findings: In 2019, rates per 100,000 population were 16,983 (95% UI 12,823 – 21,630) for MDs, 3,891 (3,020 - 4,905) for SUDs, and 89·1 (63·8 - 123·1) for self-harm. In terms of disability, anxiety contributed to 647·3 (432–912·3) YLDs, while in terms of premature death, self-harm contributed to 319·6 (248·9–412·8) YLLs, per 100,000 population. Over the 30 years studied, YLDs increased in eating disorders (14·9%;9·4-20·1) and drug use disorders (16·9%;8·9-26·3), and decreased in idiopathic developmental intellectual disability (–29·1%;23·8-38·5). YLLs decreased in self-harm (–27·9%;38·3-18·7). Variations were found by sex, age-group and country. The burden of SUDs and self-harm was higher in countries with lower SDI, MDs were associated with SUDs. Interpretation: Mental health conditions represent an important burden among young people living in Europe. National policies should strengthen mental health, with a specific focus on young people. Funding: The Bill and Melinda Gates Foundation, The Bill and Melinda Gates Foundation
Published: 2022

13. Retinal photograph-based deep learning algorithms for myopia and a blockchain platform to facilitate artificial intelligence medical research: a retrospective multicohort study

Author: Yechao Yang, Shaohua Li, Yee Ling Wong, Hanruo Liu, Shu Yen Lee, Cheng Chen, Yih Chung Tham, Quan V Hoang, Tien Yin Wong, Wei-Chi Wu, Kyoko Ohno-Matsui, Tyler Hyungtaek Rim, Seang-Mei Saw, Haotian Lin, Marcus Ang, Zhe Xiao, Ayesha Anees, Ching-Yu Cheng, Youxin Chen, Yen-Po Chen, Leopold Schmetterer, Weihong Yu, Xiaofeng Lei, Donald T. Tan, Rick Siow Mong Goh, Chee Wai Wong, Ian Yew San Yeo, Tien-En Tan, Vinay Nangia, Zengxiang Li, Xinxing Xu, Edmund Yick Mun Wong, Audrey Chia, Ningli Wang, Ya Xing Wang, Gemmy Cheung, Mukharram M. Bikbov, Yong Liu, Daniel Shu Wei Ting, and Jost B. Jonas
Subjects: Biomedical Research, Computer science, Computer applications to medicine. Medical informatics, MEDLINE, R858-859.7, Medicine (miscellaneous), Datasets as Topic, Health Informatics, Proof of Concept Study, Retina, Cohort Studies, Macular Degeneration, Blockchain, Deep Learning, Health Information Management, Artificial Intelligence, Myopia, Humans, Decision Sciences (miscellaneous), Medical diagnosis, Grading (education), Retrospective Studies, Receiver operating characteristic, business.industry, Deep learning, High myopia, Reproducibility of Results, Medical research, ROC Curve, Area Under Curve, Artificial intelligence, business, Algorithm, Algorithms
Abstract: Summary Background By 2050, almost 5 billion people globally are projected to have myopia, of whom 20% are likely to have high myopia with clinically significant risk of sight-threatening complications such as myopic macular degeneration. These are diagnoses that typically require specialist assessment or measurement with multiple unconnected pieces of equipment. Artificial intelligence (AI) approaches might be effective for risk stratification and to identify individuals at highest risk of visual loss. However, unresolved challenges for AI medical studies remain, including paucity of transparency, auditability, and traceability. Methods In this retrospective multicohort study, we developed and tested retinal photograph-based deep learning algorithms for detection of myopic macular degeneration and high myopia, using a total of 226 686 retinal images. First we trained and internally validated the algorithms on datasets from Singapore, and then externally tested them on datasets from China, Taiwan, India, Russia, and the UK. We also compared the performance of the deep learning algorithms against six human experts in the grading of a randomly selected dataset of 400 images from the external datasets. As proof of concept, we used a blockchain-based AI platform to demonstrate the real-world application of secure data transfer, model transfer, and model testing across three sites in Singapore and China. Findings The deep learning algorithms showed robust diagnostic performance with areas under the receiver operating characteristic curves [AUC] of 0·969 (95% CI 0·959–0·977) or higher for myopic macular degeneration and 0·913 (0·906–0·920) or higher for high myopia across the external testing datasets with available data. In the randomly selected dataset, the deep learning algorithms outperformed all six expert graders in detection of each condition (AUC of 0·978 [0·957–0·994] for myopic macular degeneration and 0·973 [0·941–0·995] for high myopia). We also successfully used blockchain technology for data transfer, model transfer, and model testing between sites and across two countries. Interpretation Deep learning algorithms can be effective tools for risk stratification and screening of myopic macular degeneration and high myopia among the large global population with myopia. The blockchain platform developed here could potentially serve as a trusted platform for performance testing of future AI models in medicine. Funding None.
Published: 2021

14. Estimated pulse wave velocity and cardiovascular events in Chinese

Author: Jingli Gao, Jost B. Jonas, Chunpeng Ji, Zhe Huang, Shuohua Chen, Shouling Wu, and Guodong Wang
Subjects: medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, All-cause death, Arteriosclerosis, Kailuan study, Carotid-ankle pulse wave velocity, Internal medicine, Internal Medicine, medicine, Myocardial infarction, Pulse wave velocity, Stroke, Brachial-ankle pulse wave velocity, business.industry, Cerebral infarction, Incidence (epidemiology), Hazard ratio, medicine.disease, Cardiovascular disease, Confidence interval, Blood pressure, lcsh:RC666-701, Hypertension, Cardiology, Cardiology and Cardiovascular Medicine, business, Research Paper
Abstract: The estimated pulse-wave velocity (ePWV) as measure for arterial wall stiffness is associated with an increased risk of cardiovascular disease (CVDs) and all-cause death in Western populations. We investigated the association between ePWV and the incidence of CVDs (myocardial infarction, cerebral infarction, cerebral hemorrhage) and all-cause death in Chinese. The community-based longitudinal Kailuan Study included 98,348 participants undergoing biennial clinical examinations. During a mean follow-up of 10.32 ± 2.14 years, 6967 CVD events (myocardial infarction, n = 1610; cerebral infarction, n = 4634; cerebral hemorrhage, n = 1071) and 9780 all-cause deaths occurred. Stratified by age, sex and presence of cardiovascular risk factors, the incidence of CVDs and all-cause death were higher (P < 0.01) in individuals with ePWV values ≥ 10 m/s than in those with ePWV values < 10 m/s. After adjusting for age, age squared and other conventional cardiovascular risk factors, an ePWV value of ≥10 m/s or each ePWV increase by 1 m/s increased (P < 0.01) the risk for CVDs by 32% (Hazard ratio (HR):1.32; 95% confidence interval (CI):1.23-1.42) and 22% (HR:1.22; 95%CI:1.18-1.27), respectively, and increased the risk for all-cause death significantly (P < 0.01) by 28% (HR:1.28; 95%CI:1.20-1.37) and 10% (HR:1.10; 95%CI:1.07-1.13), respectively. The mean brachial-ankle PWV, measured in 43,208 individuals, was 15.30 ± 3.51 cm/s, with a mean difference of 6.45 m/s (95% limits of agreement:1.24-11.7) to the ePWV. Independently of cardiovascular risk factors, ePWV was associated with CVDs and all-cause mortality in Chinese.
Published: 2020

15. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Soufiane Boufous, Yousef Veisani, Mehran Asadi-Aliabadi, Sharath Burugina Nagaraja, Maziar Moradi-Lakeh, Getachew Mullu Kassa, Edward J Mills, Dimas Ria Angga Pribadi, William James Dangel, Mohamad-Hani Temsah, Catherine O. Johnson, Gregory A. Roth, Giuseppe Gorini, Fariborz Mansour-Ghanaei, Alberto Ortiz, Samad Azari, Assefa Ayalew Ayalew Ayalew Gebreslassie, Salime Goharinezhad, Stephanie R. M. Zimsen, Peng Zheng, Michael Assmus, Elisabetta Pupillo, Bach Xuan Tran, Lal B. Rawal, Narayanaswamy Venketasubramanian, Noushin Mohammadifard, Stephen S Lim, Ata Rafiee, Maria Inês Schmidt, Vincent C. Iannucci, Suzanne Lyn Barker-Collo, Leah E. Cahill, Tauseef Ahmad, Platon D. Lopukhov, Kazumasa Yamagishi, Abdullah Al Mamun, Iqbal R. F. Elyazar, Giovanni Damiani, Mohammad Hossein Bakhshaei, Mehdi Fazlzadeh, Virginia Núñez-Samudio, Alyssa Pennini, Dietrich Plass, Atkilt Esaiyas Etisso, Gebre Teklemariam Demoz, Alexandrea Watson, Arvin Haj-Mirzaian, Paul S Briant, Frank B. Osei, Blair R. Bumgarner, Maciej Banach, Ravensara S. Travillian, Kai-Lan Chang, Shirin Djalalinia, Hasan Yusefzadeh, Silvano Gallus, Seyyed Meysam Mousavi, Bernhard T. Baune, Aaron van Donkelaar, Azeem Majeed, Hans Kromhout, Robert Ancuceanu, Blessing J. Akombi, Pushpendra Singh, Nayu Ikeda, William M. Gardner, Zahid A Butt, Mohammad Abdollahi, Temesgen Yihunie Akalu, Rahman Shiri, Benn Sartorius, Ai-Min Wu, Bing Fang Hwang, Flavia M. Cicuttini, Hiroyasu Iso, Luis Camera, Amin Soheili, Félix Carvalho, Yun Jin Kim, Caleb Mackay Salpeter Irvine, Mehdi Mirzaei-Alavijeh, Iman Halvaei, Saqib Ali, Giulio Castelpietra, Catalina Liliana Andrei, Ali Kazemi Karyani, Parkes J Kendrick, Hamidreza Haririan, Lucas Guimarães Abreu, Mukhammad David Naimzada, Jeff T. Zhao, Samiah Alam, Sorin Hostiuc, Shaun Wen Huey Lee, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Cyrus Alinia, Takahiro Tabuchi, Manu Raj Mathur, Søren Thorgaard Skou, Thomas Khaled Dwayne Classen, Reza Heidari-Soureshjani, Massimo Cirillo, Nikita Otstavnov, Mehdi Bohluli, Ruth W. Kimokoti, Animut Tagele Tamiru, Masoumeh Sadeghi, Mohammad Ali Jahani, Itamar S. Santos, Mekdes Tigistu Yilma, Lars Johansson, Arielle Wilder Eagan, Nevine El Nahas, Silvia Schiavolin, Kevin D. Shield, Dinh-Toi Chu, Shiva Borzouei, Paul S. F. Yip, Beatrix Haddock, Gianfranco Alicandro, Vasily Vlassov, Deanna Anderlini, Giuseppe Remuzzi, Khalid A Altirkawi, Farahnaz Joukar, Aso Mohammad Darwesh, Ratilal Lalloo, Panniyammakal Jeemon, Rohollah Kalhor, Daniel Youngwhan Cho, Weijia Fu, João Pedro Silva, Rodrigo Sarmiento-Suarez, Seth Christopher Yaw Appiah, Mehdi Ahmadi, Jacob Olusegun Olusanya, José Neves, Gaorui Guo, Tomas Y. Yeheyis, John S. Ji, Charles D. H. Parry, Maryam Ghadimi, Seyed-Mohammad Fereshtehnejad, Serge Resnikoff, Anna E. Torre, Vinod C Nayak, Jamileh Shadid, Susanne Breitner, Mohammad Khammarnia, Mathilde Touvier, Ensiyeh Jenabi, Hosna Janjani, Floriane Ausloos, Irmina Maria Michalek, Alexandra S. Boon-Dooley, Jessica A. Cruz, Syed Mohamed Aljunid, Abiodun M. Adeoye, André Faro, Bartosz Miazgowski, Jobert Richie Nansseu, Erin C Mullany, Giannina Ferrara, Martin McKee, Emmanuel Peprah, Oommen John, Reza Saeedi, Yasser Vasseghian, Dragos Virgil Davitoiu, Sarah Wulf Hanson, Yingxi Zhao, Omid Shafaat, Ali Rajabpour-Sanati, Farid Najafi, Ana Maria Mantilla Herrera, Fatemeh Rajati, Tarun Gupta, Łukasz Szumowski, Mohammed Ibrahim Mohialdeen Gubari, Peter Njenga Keiyoro, Dharmesh Kumar Lal, Zhi Jiang Zhang, Osayomwanbo Osarenotor, Tanvir M. Huda, Perminder S. Sachdev, Farhad Ghamari, Era Upadhyay, Vivek Kumar, Guoqing Hu, Vinay Nangia, Vladimir Andreevich Korshunov, Saeed Shahabi, Golnaz Heidari, Ashraf Nabhan, Robert C. Reiner, Aziz Rezapour, Justin J. Lang, Rakhi Dandona, Josephine W. Ngunjiri, Anna-Karin Danielsson, André Karch, Filippo Ariani, Ahmed Abdelalim, Masih Tajdini, Stefanos Tyrovolas, Mohamed Hsairi, Jae Il Shin, Jasvinder A. Singh, Meghan D. Mooney, Fiona B. Bennitt, Hesam Alizade, Segun Emmanuel Ibitoye, Pradhum Ram, Soraya Siabani, Evanson Z. Sambala, Reza Malekzadeh, Falk Schwendicke, Lalit Dandona, Masoud Moradi, Molly R Nixon, Roya Mirzaei, Rachel Feldman, Hosni Salem, Alberto L. García-Basteiro, Lorainne Tudor Car, Sharareh Eskandarieh, Ramesh Holla, Ritesh G. Menezes, Taraneh Yousefinezhadi, Hai Quang Pham, Hamideh Salimzadeh, Luisa Sorio Flor, Priya Rathi, Ali Bijani, Harvey Whiteford, Shanshan Li, Aleksandr Y. Aravkin, Joshua A. Salomon, Franz Castro, Lisa M. Force, Abdilahi Yousuf Yousuf, Mina Anjomshoa, Ken Takahashi, Maigeng Zhou, Telma Zahirian Moghadam, Maseer Khan, Irina Filip, Santi Martini, Randah R. 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Cross, Vera Marisa Costa, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Odgerel Chimed-Ochir, Sonia Rodríguez-Ramírez, Bo Norrving, Kerem Shuval, Jacob L. Stubbs, Muhammad Ali, Shuhei Nomura, Man Mohan Mehndiratta, Chisom Joyqueenet Akunna, Abdollah Mohammadian-Hafshejani, Navid Rabiee, Dana Bryazka, Hussen Mohammed, Asadollah Gholamian, Ashley Marks, Rizwan Kalani, Molly E. Herbert, Islam Y. Elgendy, Moritz U. G. Kraemer, Chuanhua Yu, Suzanne Polinder, Pascual R. Valdez, Jennifer Rickard, Kylie Ball, Turki Alanzi, Mohsen Bayati, Hamed Mirzaei, Christopher M Odell, Amira Shaheen, Ziad A. Memish, Thirunavukkarasu Sathish, Michael A. Piradov, Hamed Kalani, Lorenzo Monasta, Christopher S Yilgwan, Desalegn Getnet Demsie, Riaz Uddin, Rizwan Suliankatchi Abdulkader, Vinay Srinivasan, Hamid Ahmadieh, Claudio Alberto Dávila-Cervantes, Raffaele Palladino, Chukwudi A Nnaji, Mika Shigematsu, Stein Emil Vollset, Abbas Sheikhtaheri, Paulo A. Lotufo, Nasir Salam, Binyam Minuye Birihane, Mohammad Ali Mansournia, Tomislav Mestrovic, Samer Hamidi, Rajesh Sagar, Mayowa O. Owolabi, Kara Estep, Ester Cerin, Michael T. Chung, Simon Øverland, Amir Taherkhani, Sheng Chia Chung, Martin Amogre Ayanore, Nikolaos Dervenis, Joan B. Soriano, Tahereh Javaheri, Victor Adekanmbi, Seid Tiku Mereta, Gbenga A. Kayode, Christopher R. Cederroth, Razique Anwer, Rajan Nikbakhsh, Kaja Abbas, Fatemeh Heydarpour, Louisa Degenhardt, Tahiya Alam, Mohammad Miri, Alibek Mereke, David Laith Rawaf, Ippazio Cosimo Antonazzo, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, Desta Debalkie Atnafu, Davide Sattin, Moslem Soofi, Edris Hasanpoor, Krittika Bhattacharyya, Mika Kivimäki, Nikolay Ivanovich Briko, Joanna L Whisnant, Christopher J L Murray, Simin Mouodi, Alize J. Ferrari, Damian Santomauro, Katrin Burkart, Tudorel Andrei, Alberto Baldasseroni, Hafiz Ansar Rasul Suleria, Valery L. Feigin, Nauman Khalid, Ewerton Cousin, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Shankar M Bakkannavar, Themba G.G. Ginindza, Sadaf G. Sepanlou, Sheikh Mohammed Shariful Islam, Sanjay Basu, Getinet Ayano, Paula Moraga, Soheil Hassanipour, Jason A. Anderson, Catherine Bisignano, Iyad Sultan, Deepak Kumar Pasupula, Keivan Ahmadi, Fariba Dorostkar, Rajeev Gupta, David M. Pereira, Mustafa Z. Younis, Adel Spotin, Rasmus Havmoeller, Yeshambel T. Nigatu, Barthelemy Kuate Defo, Mithila Faruque, Alan D. Lopez, Shailesh Advani, Behshad Naghshtabrizi, Shane D. Morrison, Inga Dora Sigfusdottir, Konrad Pesudovs, Anna Gershberg Hayoon, Raaj Kishore Biswas, Reshmi Bhageerathy, H. Dean Hosgood, Giulia Carreras, Sarika Chaturvedi, James L. Fisher, In-Hwan Oh, G Anil Kumar, Christoph Nowak, Vijay Kumar Chattu, Puja C Rao, Marcel Ausloos, Ali Kabir, Rannveig Sigurvinsdottir, Leeberk Raja Inbaraj, Edgar Denova-Gutiérrez, Rafael Tabarés-Seisdedos, Minh Nguyen, Ashkan Afshin, Payman Salamati, Colin Angus, Mona M. 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Campos-Nonato, Biniyam Sahiledengle Geberemariyam, Godfrey Mutashambara Rwegerera, Alaa Badawi, James Leigh, Morteza Arab-Zozani, Kyle E. Simpson, Muluken Bekele Sorrie, Roghiyeh Faridnia, Vivekanand Jha, Tomasz Miazgowski, Aaron J Cohen, Chukwuma David Umeokonkwo, Alessandra Lugo, Adhanom Gebreegziabher Baraki, Akshaya Srikanth Bhagavathula, Caitlyn Steiner, Gholamreza Roshandel, Cuong Tat Nguyen, Tania G Sánchez-Pimienta, Ahamarshan Jayaraman Nagarajan, Laura Kemmer, Ihoghosa Osamuyi Iyamu, Seyedeh Zahra Masoumi, Vivian Chia-Rong Hsieh, Kris J. Krohn, Phoebe Anne Rhinehart, Sarah Wozniak, Sahar Saeedi Moghaddam, Kate E. LeGrand, Christian Kieling, Vahid Yazdi-Feyzabadi, Robin Room, Zelalem Nigussie Azene, Kelly Cercy, Paul H. Lee, Stanislav S. Otstavnov, Dinesh Bhandari, Rafael Alves Guimarães, Zemenu Tadesse Tessema, Aziz Sheikh, Michellr L. Bell, Marwa Rashad Salem, Kirsten E. Wiens, Emma U.R. Smith, Hassan Abolhassani, Cristiano Piccinelli, Kedir Hussein Abegaz, G.K. Mini, Christian Razo, Manuela L. Ferreira, Diego De Leo, Francesco Saverio Violante, Aristidis Tsatsakis, Zahra Sadat Dibaji Forooshani, Tea Lallukka, Dickson A. Amugsi, Anna Poznańska, Graeme J. Hankey, Kewal Krishan, Maryam Zamanian, Eirini Skiadaresi, Jai K Das, Felix Greaves, Tessa M. Pilz, Sameer Vali Gopalani, Mansour Ghafourifard, M. DeLang, Morteza Mahmoudi, Alton Lu, Brian J. Hall, Ravi Prakash Jha, David Edvardsson, Xiu Ju George Zhao, Farshad Farzadfar, Hadi Hassankhani, Samuel M. Ostroff, Gerhard Sulo, Keyghobad Ghadiri, Neeraj Bhala, Stefan Lorkowski, Mohammad Rabiee, Sivan Yegnanarayana Iyer Saraswathy, Amirhossein Sahebkar, Rashid Abdi Guled, Abdallah M. Samy, Roman Topor-Madry, Michal Grivna, Afsaneh Arzani, Ayesha Humayun, Simin Liu, Maryam Khayamzadeh, Davoud Adham, Ahad Bakhtiari, Shafiu Mohammed, Paolo Lauriola, Abbas Mosapour, Sophia Emmons-Bell, Khurshid Alam, Rajat Das Gupta, Matilde Leonardi, Muktar Beshir Ahmed, Jeffrey V. Lazarus, Mohamed M. 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S. B., Caetano Dos Santos, F. L., Camera, L. A., Elyazar, I. R. F., Ayalew Gebreslassie, A. A. A., Ginindza, T. G., Matin, B. K., Morgado-Da-Costa, J., Khaneghah, A. M., Mahesh, P. A., Toroudi, H. P., Syed, Z. Q., Salem, M. R., Skou, S. T., Tovani-Palone, M. R., Tudor Car, L. T., and Moghadam, T. Z.
Subjects: Male, Nutritional Sciences, Specific risk, Contaminación del Aire Interior, 030204 cardiovascular system & hematology, Socioeconomic Factor, systematic analysis, Global Health, Body Mass Index, Global Burden of Disease, Health Risk Behavior, Health Risk Behaviors, Disease studies, 0302 clinical medicine, Risk Factors, METABOLIC RISKS, 030212 general & internal medicine, 11 Medical and Health Sciences, Factores de Riesgo, 2. Zero hunger, education.field_of_study, Public health, Injuries, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, GBD, risck factors, attributable burden of disease, 3142 Public health care science, environmental and occupational health, 3. Good health, Relative risk, Environmental health, Health, Hypertension, Global Burden of Diseases, Injuries, Risk Factors, A990 Medicine and Dentistry not elsewhere classified, Female, Leading risk factors, Global Health Metrics, Cohort study, Human, medicine.medical_specialty, Substance-Related Disorders, Population, UNITED-STATES, Risk Assessment, DIET, ITC-HYBRID, 03 medical and health sciences, Life Expectancy, MORTALITY, DISABILITY, POLLUTION, CLUSTERS, SDG 3 - Good Health and Well-being, General & Internal Medicine, medicine, Humans, Global Burden of Disease Study, Risk factor, education, Global burden, business.industry, Risk Factor, Malnutrition, Klinisk medicin, Global Burden of Diseases, Environmental Exposure, medicine.disease, Enfermedades, purl.org/pe-repo/ocde/ford#3.02.00 [https], Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Years of potential life lost, Socioeconomic Factors, Risk factors, Disease study, Hyperglycemia, ITC-ISI-JOURNAL-ARTICLE, NA, Clinical Medicine, business, RA
Abstract: Background Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. Methods GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk-outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk-outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk-outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. Findings The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10.8 million (95% uncertainty interval [UI] 9.51-12.1) deaths (19.2% [16.9-21.3] of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8.71 million (8.12-9.31) deaths (15.4% [14.6-16.2] of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253-350) DALYs (11.6% [10.3-13.1] of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0-9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10-24 years, alcohol use for those aged 25-49 years, and high systolic blood pressure for those aged 50-74 years and 75 years and older. Interpretation Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.
Published: 2020

16. Health sector spending and spending on HIV/AIDS, tuberculosis, and malaria, and development assistance for health: progress towards Sustainable Development Goal 3

Author: Priya Rathi, Ritesh G. Menezes, Edris Hasanpoor, Sanni Yaya, Mohsen Bayati, Maciej Banach, Raffaele Palladino, Mikhail Sergeevich Zastrozhin, Siamak Sabour, Theo Vos, Tuomo J. Meretoja, Dimas Ria Angga Pribadi, Shahin Soltani, Simona Cătălina Ștefan, Behzad Karami Matin, Cyrus Alinia, Tudorel Andrei, Mehdi Bohluli, Nikita Otstavnov, Yanfang Su, Mohammad Ali Mansournia, Simon I. Hay, Mansour Ghafourifard, Songhomitra Panda-Jonas, Pushpendra Singh, Salman Rawaf, Morteza Arab-Zozani, Robert Ancuceanu, Samer Hamidi, Maarten J. Postma, Vijay Kumar Chattu, Ted R. Miller, Stanislav S. Otstavnov, Gbenga A. Kayode, Chhabi Lal Ranabhat, João Vasco Santos, Savita Lasrado, Jonathan F. Mosser, Chaw Yin Myint, Mihajlo Jakovljevic, Masoud Moghadaszadeh, Tanvir M. Huda, Fakher Rahim, Seyedeh Zahra Masoumi, Yingxi Zhao, Aziz Sheikh, Subramanian Senthilkumaran, Sheikh Mohammed Shariful Islam, Fariborz Mansour-Ghanaei, Andrew T Olagunju, Atif Amin Baig, Ali H. Mokdad, Anders Larsson, Atte Meretoja, Bach Xuan Tran, Lal B. Rawal, Brandon Cunningham, Vahid Alipour, Sowmya J. Rao, Anamika Pandey, Vahid Yazdi-Feyzabadi, Salime Goharinezhad, Angela E Micah, Leticia Avila-Burgos, Hayley N Stutzman, Farshad Farzadfar, M. Mofizul Islam, Sharareh Eskandarieh, Saqib Ali, Srikanta Banerjee, Zhi-Jiang Zhang, Anirudh Kotlo, Ravensara S. Travillian, Aziz Rezapour, Huong Lan Thi Nguyen, Sergio I. Prada, Biagio Simonetti, Maitreyi Sahu, Sadaf G. Sepanlou, Carlos A Castañeda-Orjuela, Hoa Thi Do, Farahnaz Joukar, Aso Mohammad Darwesh, Syed Mohamed Aljunid, Modhurima Moitra, In-Hwan Oh, Ayman Grada, Kenji Shibuya, Sojib Bin Zaman, Steven D Bachmeier, Hilda L Harb, Edson Serván-Mori, Bahram Mohajer, Van C. Lansingh, Ali Almasi, German Martinez, Till Bärnighausen, Reza Malekzadeh, Adam E. Berman, Matthew T. Schneider, Michael K. Hole, Reza Rawassizadeh, Bing-Fang Hwang, Bianca S. Zlavog, Mohammad Rabiee, Moses K. Muriithi, Anton C Harle, Mokhtar Mahdavi, Yohannes Kinfu, Olatunde Aremu, Cristiana Abbafati, Nelson Alvis-Guzman, Joseph L Dieleman, Lucero Cahuana-Hurtado, Abdollah Mohammadian-Hafshejani, Soewarta Kosen, Zeleke Hailemariam Abebo, Muge Cevik, Hassan Abolhassani, Farnam Mohebi, Job F M van Boven, Nataliya Foigt, Neda Milevska Kostova, Abdallah M. Samy, Roman Topor-Madry, Golsum Tsakalos, Benjamin B. Massenburg, Spencer L. James, Erkin M. Mirrakhimov, Miloje Savic, Mehdi Hosseinzadeh, Sawyer W Crosby, Ayesha Humayun, Hamidreza Setayesh, G Anil Kumar, Juan Sanabria, Jalal Arabloo, Milena M Santric Milicevic, Ai Koyanagi, Shokofeh Maleki, Junjie Wu, Nathaniel J Henry, Efat Mohamadi, Francesco Saverio Violante, Samad Azari, Delia Hendrie, Ahad Bakhtiari, Olayinka Stephen Ilesanmi, Pankaj Bhardwaj, Ahamarshan Jayaraman Nagarajan, Adnan Kisa, Masood Ali Shaikh, Shafiu Mohammed, Justice Nonvignon, Firooz Esmaeilzadeh, Eduardo A. Undurraga, Khurshid Alam, Muktar Beshir Ahmed, Mohamed M. Gad, Mikk Jürisson, Usman Iqbal, Chuanhua Yu, Luis Camera, Mohammad Ali Jahani, Abigail Chapin, Pascual R. Valdez, Reinhard Busse, Tomislav Mestrovic, Paul S. F. Yip, Christopher J L Murray, Jacob Olusegun Olusanya, Salah Eddin Karimi, Mustafa Z. Younis, Michael R.M. Abrigo, Rahul R. Zende, Mina Anjomshoa, Shane D. Morrison, Marcel Ausloos, Bruno Piassi Sao Jose, Zohre Javaheri, Saravanan Muthupandian, Valentin Yurievich Skryabin, Endalkachew Worku Mengesha, Lalit Dandona, Jacek Jerzy Jozwiak, Omar Mukhtar Salman, Rakhi Dandona, Mojtaba Bagherzadeh, Mostafa Dianatinasab, Reza Mohammadpourhodki, Seyed Sina Naghibi Irvani, Nancy Fullman, Claudiu Herteliu, Andreea Mirica, Jasvinder A. Singh, Amin Soheili, Lee Ling Lim, Charles D.A. Wolfe, Catalina Liliana Andrei, Ali Kazemi Karyani, Bolajoko O. Olusanya, Carl Abelardo T. Antonio, Tommi Vasankari, Jean Jacques Noubiap, Mehdi Naderi, Jagadish Rao Padubidri, Bernhard T. Baune, Navid Rabiee, Mark G. Shrime, Mayowa O. Owolabi, Lorenzo G. Mantovani, Desta Debalkie Atnafu, Vasily Vlassov, Kyle E. Simpson, Sorin Hostiuc, Shaun Wen Huey Lee, Cuong Tat Nguyen, Ian E Cogswell, Tesleem Kayode Babalola, Sanjay Basu, Hassan Haghparast Bidgoli, Leila Doshmangir, Marcos Roberto Tovani-Palone, Maha El Tantawi, Obinna Onwujekwe, Mohammad Ali Sahraian, Ahmed Omar Bali, Joshua A. Salomon, Hamidreza Komaki, David Laith Rawaf, Zoubida Zaidi, Hassan Magdy Abd El Razek, Reshmi Bhageerathy, Emilie R Maddison, Naohiro Yonemoto, Ahmad Ghashghaee, Asadollah Gholamian, Ferrán Catalá-López, Stefan Kohler, Rafael Tabarés-Seisdedos, Anwar Faraj, Rafael Lozano, Rufus Akinyemi, Florian Fischer, Jost B. Jonas, Dian Kusuma, Martin Amogre Ayanore, Rohollah Kalhor, Falk Schwendicke, Seyyed Meysam Mousavi, Micah, A. E., Su, Y., Bachmeier, S. D., Chapin, A., Cogswell, I. E., Crosby, S. W., Cunningham, B., Harle, A. C., Maddison, E. R., Moitra, M., Sahu, M., Schneider, M. T., Simpson, K. E., Stutzman, H. N., Tsakalos, G., Zende, R. R., Zlavog, B. 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School of Medicine, University of St Andrews. Infection and Global Health Division, Groningen Research Institute for Asthma and COPD (GRIAC), Value, Affordability and Sustainability (VALUE), and Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET)
Subjects: Economic growth, Financing, Government, Psychological intervention, HIV Infections, burden of disease, 030204 cardiovascular system & hematology, DISEASE, ALLOCATION, 0302 clinical medicine, RA0421, RA0421 Public health. Hygiene. Preventive Medicine, Sustainable development, Global health, health economics, Healthcare Financing, HIV Infection, 030212 general & internal medicine, 10. No inequality, 11 Medical and Health Sciences, DALY, Healthy lives, 1. No poverty, Public Health, Global Health, Social Medicine and Epidemiology, 3rd-DAS, General Medicine, Sustainable Development, 3. Good health, tuberculosis, IMPOVERISHMENT, TERRITORIES, Financing, Human, Financing, Personal, Resource (biology), Tuberculosi, 195 COUNTRIES, Developing Countrie, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Acquired immunodeficiency syndrome (AIDS), General & Internal Medicine, SYSTEMATIC ANALYSIS, medicine, Humans, Burden, HIV/AIDS, tubercolosis, malaria, Human resources, Developing Countries, Government, Acquired Immunodeficiency Syndrome, Health economics, business.industry, DISABILITY, CATASTROPHE, Global Burden of Disease Health Financing Collaborator Network, GLOBAL BURDEN, medicine.disease, Malaria, SDG, health sector spending, development assistant for health, Health Expenditure, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, 3121 General medicine, internal medicine and other clinical medicine, NA, Health Expenditures, business, EXPENDITURE
Abstract: BACKGROUND: Sustainable Development Goal (SDG) 3 aims to "ensure healthy lives and promote well-being for all at all ages". While a substantial effort has been made to quantify progress towards SDG3, less research has focused on tracking spending towards this goal. We used spending estimates to measure progress in financing the priority areas of SDG3, examine the association between outcomes and financing, and identify where resource gains are most needed to achieve the SDG3 indicators for which data are available. METHODS: We estimated domestic health spending, disaggregated by source (government, out-of-pocket, and prepaid private) from 1995 to 2017 for 195 countries and territories. For disease-specific health spending, we estimated spending for HIV/AIDS and tuberculosis for 135 low-income and middle-income countries, and malaria in 106 malaria-endemic countries, from 2000 to 2017. We also estimated development assistance for health (DAH) from 1990 to 2019, by source, disbursing development agency, recipient, and health focus area, including DAH for pandemic preparedness. Finally, we estimated future health spending for 195 countries and territories from 2018 until 2030. We report all spending estimates in inflation-adjusted 2019 US$, unless otherwise stated. FINDINGS: Since the development and implementation of the SDGs in 2015, global health spending has increased, reaching $7·9 trillion (95% uncertainty interval 7·8-8·0) in 2017 and is expected to increase to $11·0 trillion (10·7-11·2) by 2030. In 2017, in low-income and middle-income countries spending on HIV/AIDS was $20·2 billion (17·0-25·0) and on tuberculosis it was $10·9 billion (10·3-11·8), and in malaria-endemic countries spending on malaria was $5·1 billion (4·9-5·4). Development assistance for health was $40·6 billion in 2019 and HIV/AIDS has been the health focus area to receive the highest contribution since 2004. In 2019, $374 million of DAH was provided for pandemic preparedness, less than 1% of DAH. Although spending has increased across HIV/AIDS, tuberculosis, and malaria since 2015, spending has not increased in all countries, and outcomes in terms of prevalence, incidence, and per-capita spending have been mixed. The proportion of health spending from pooled sources is expected to increase from 81·6% (81·6-81·7) in 2015 to 83·1% (82·8-83·3) in 2030. INTERPRETATION: Health spending on SDG3 priority areas has increased, but not in all countries, and progress towards meeting the SDG3 targets has been mixed and has varied by country and by target. The evidence on the scale-up of spending and improvements in health outcomes suggest a nuanced relationship, such that increases in spending do not always results in improvements in outcomes. Although countries will probably need more resources to achieve SDG3, other constraints in the broader health system such as inefficient allocation of resources across interventions and populations, weak governance systems, human resource shortages, and drug shortages, will also need to be addressed. For complete list of authors see http://dx.doi.org/10.1016/S0140-6736(20)30608-5
Published: 2020

17. Glaucoma neurodegeneration and myopia

Author: Ya Xing Wang, Jost B. Jonas, and Songhomitra Panda-Jonas
Subjects: endocrine system, medicine.medical_specialty, genetic structures, business.industry, fungi, Neurodegeneration, Glaucoma, Retinal, Axial length, medicine.disease, Glaucomatous optic neuropathy, eye diseases, Optic neuropathy, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, medicine.anatomical_structure, chemistry, Ophthalmology, medicine, Optic nerve, sense organs, business, 030217 neurology & neurosurgery, Optic disc
Abstract: Beyond a cut-off value of approximately 26.5mm, the prevalence of glaucomatous or glaucoma-like optic neuropathy (GON) increases with longer axial length. In a hospital-based study, the prevalence of GON was 42% in eyes with an axial length of ≥30mm. Myopia-associated histological changes potentially associated with the increased GON prevalence are an elongation and thinning of the lamina cribrosa and peripapillary scleral flange. Correspondingly, clinical parameters associated with an increased GON prevalence were an enlargement of the optic disc and parapapillary delta zone. In addition to GON, a non-glaucomatous optic nerve damage can occur in highly myopic eyes, potentially due to a parapapillary gamma zone-associated lengthening of the retinal nerve fibers in the papillo-macular bundle. Clinically, GON and non-glaucomatous optic neuropathy should be ruled out in any highly myopic eye, in particular in those with a large optic disc, gamma zone and delta zone.
Published: 2020

18. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Sorin Hostiuc, Shaun Wen Huey Lee, Jorge R. Ledesma, Carsten Flohr, Masoumeh Sadeghi, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Cyrus Alinia, Mehdi Bohluli, Félix Carvalho, Yun Jin Kim, Catalina Liliana Andrei, Seyyed Meysam Mousavi, Bernhard T. Baune, Ehsan Ahmadpour, Dinh-Toi Chu, Beatrix Haddock, Gianfranco Alicandro, Vasily Vlassov, Mohammad Taghi Khodayari, Gianna Gayle Herrera Amul, Arash Tehrani-Banihashemi, Govinda Prasad Dhungana, Fereshteh Ansari, Michael K. Hole, Azeem Majeed, Iman Halvaei, Saqib Ali, Arianna Maever L. Amit, Tomas Y. Yeheyis, John S. Ji, Martin McKee, Jamileh Shadid, Leonardo Roever, Peng Jia, Ettore Beghi, Pablo M. Lavados, Young Eun Kim, Vahid Alipour, Sowmya J. Rao, Ahmad Daryani, Cathleen Keller, Ibrahim Abdollahpour, Nicole K. DeCleene, Ebrahim Babaee, Saman Esmaeilnejad, Boris Bikbov, William M. Gardner, Lydia M. Haile, Luca Ronfani, Azalea M. Thomson, Irena Ilic, Ruth W. Kimokoti, Yingxi Zhao, Guoqing Hu, Mehran Shams-Beyranvand, Ilais Moreno Velásquez, Nathaniel J. Henry, Brijesh Sathian, Daniel Kim, Peter Memiah, Mohammad Hadi Abbasi, Andrea Farioli, Zahra Kamiab, Bolajoko O. Olusanya, Matthew C. Doxey, Tommi Vasankari, Hamideh Salimzadeh, Luisa Sorio Flor, Priya Rathi, Shanshan Li, Tanvir M. Huda, Dillon O Sylte, Rosario Cárdenas, Agegnehu Bante, Helen Ippolito, Alyssa Acebedo, Jeffrey D. Stanaway, Anwar Faraj, João Pedro Silva, Amin Mousavi Khaneghah, Pushpendra Kumar, Sangram Kishor Patel, Josephine W. Ngunjiri, Holly E. Erskine, Eugene Sobngwi, Filippo Ariani, Shane D. Morrison, Mohammad Aghaali, Meghan D. Mooney, Vera Marisa Costa, Palash Chandra Banik, Rupak Desai, Ken Takahashi, Maigeng Zhou, Morteza Oladnabi, Bogdan Oancea, Daniela Ribeiro, Mohammad Farahmand, Irmina Maria Michalek, Yetunde O. John-Akinola, Khem Narayan Pokhrel, Emilie R Maddison, Syed Mohamed Aljunid, Damian G. Hoy, Hosni Salem, V. Prakash, Shuhei Nomura, Inga Dora Sigfusdottir, Anders Larsson, Sharareh Eskandarieh, Abdollah Mohammadian-Hafshejani, Somayeh Bohlouli, Joana Morgado-da-Costa, Siamak Sabour, Theo Vos, Han Yong Wunrow, Khaled Khatab, Alireza Zangeneh, Ann Kristin Knudsen, Marissa B Reitsma, Hannah J. Henrikson, Randah R. Hamadeh, Tuomo J. Meretoja, Ireneous N. Soyiri, Giuseppe Grosso, Ziyad Al-Aly, Taraneh Yousefinezhadi, Joseph L Ward, Roba Khundkar, Ricardo Santiago Gomez, Reza Malekzadeh, John J. McGrath, Sandra B. Munro, Shahin Soltani, Amy E. Peden, Rufus Akinyemi, Marcel Ausloos, Naohiro Yonemoto, Bogdan Wojtyniak, Ahmad Ghashghaee, Guilherme Borges, Sadia Bibi, Farhad Islami, Hamed Mirzaei, Mohammad Ali Sahraian, M. Ashworth Dirac, Hosna Janjani, Kairat Davletov, Hermann Brenner, Yuichiro Yano, Elissa M. 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L., Department of Public Health, Clinicum, Department of Neurosciences, HUS Comprehensive Cancer Center, Environmental Sciences, Public Health, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Sálfræðideild (HR), Department of Psychology (RU), Samfélagssvið (HR), School of Social Sciences (RU), Háskólinn í Reykjavík, Reykjavik University, GBD 2019 Diseases and Injuries Collaborator, Violante FS, Department of Earth Observation Science, Faculty of Geo-Information Science and Earth Observation, and UT-I-ITC-ACQUAL
Subjects: Male, Life expectancy, Disability-Adjusted Life Year, Diseases, Disease, communicable disease, systematic analysis, Global Burden of Disease, 0302 clinical medicine, 80 and over, Medicine, 10. No inequality, Child, 11 Medical and Health Sciences, injuries, Aged, 80 and over, education.field_of_study, Sjúkdómar, DEMENTIA, FALLS, General Medicine, Forvarnir, 3. Good health, Child, Preschool, Human, GBD, Population health, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Humans, Global Burden of Disease Study, education, Aged, Spatial Analysis, Global burden, Disability, Prevention, DISABILITY, Infant, Spatial Analysi, Mortality rate, Global Burden of Disease, Diseases, Injuries, Systematic analysis, PREVENTION, Years of potential life lost, Risk factors, Disease study, ITC-ISI-JOURNAL-ARTICLE, RISK-FACTORS, Clinical Medicine, RA, Demography, Fötlun, Dánartíðni, Áhættuþættir, 030204 cardiovascular system & hematology, Risk Factors, Cause of Death, Global health, 030212 general & internal medicine, 1. No poverty, Disability-Adjusted Life Years, Public Health, Global Health, Social Medicine and Epidemiology, Middle Aged, 3142 Public health care science, environmental and occupational health, Adolescent, Adult, Age Distribution, Female, Infant, Newborn, Young Adult, Lýðheilsa, CLINICAL-TRIALS, Population, Settore MED/01 - Statistica Medica, diseases, ITC-HYBRID, Heilbrigðisvísindi, General & Internal Medicine, Mortality, Preschool, Disease burden, business.industry, Risk Factor, Klinisk medicin, Newborn, purl.org/pe-repo/ocde/ford#3.02.00 [https], Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Áverkar, Systematic analysis, NA, business
Abstract: Publisher's version (útgefin grein), Background In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990-2010 time period, with the greatest annualised rate of decline occurring in the 0-9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10-24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10-24 years were also in the top ten in the 25-49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50-74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd., Research reported in this publication was supported by the Bill & Melinda Gates Foundation; the University of Melbourne; Queensland Department of Health, Australia; the National Health and Medical Research Council, Australia; Public Health England; the Norwegian Institute of Public Health; St Jude Children's Research Hospital; the Cardiovascular Medical Research and Education Fund; the National Institute on Ageing of the National Institutes of Health (award P30AG047845); and the National Institute of Mental Health of the National Institutes of Health (award R01MH110163). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders. The authors alone are responsible for the views expressed in this Article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated, the National Health Service (NHS), the National Institute for Health Research (NIHR), the UK Department of Health and Social Care, or Public Health England; the United States Agency for International Development (USAID), the US Government, or MEASURE Evaluation; or the European Centre for Disease Prevention and Control (ECDC). This research used data from the Chile National Health Survey 2003, 2009-10, and 2016-17. The authors are grateful to the Ministry of Health, the survey copyright owner, for allowing them to have the database. All results of the study are those of the authors and in no way committed to the Ministry. The Costa Rican Longevity and Healthy Aging Study project is a longitudinal study by the University of Costa Rica's Centro Centroamericano de Poblacion and Instituto de Investigaciones en Salud, in collaboration with the University of California at Berkeley. The original pre-1945 cohort was funded by the Wellcome Trust (grant 072406), and the 1945-55 Retirement Cohort was funded by the US National Institute on Aging (grant R01AG031716). The principal investigators are Luis Rosero-Bixby and William H Dow and co-principal investigators are Xinia Fernandez and Gilbert Brenes. The accuracy of the authors' statistical analysis and the findings they report are not the responsibility of ECDC. ECDC is not responsible for conclusions or opinions drawn from the data provided. ECDC is not responsible for the correctness of the data and for data management, data merging and data collation after provision of the data. ECDC shall not be held liable for improper or incorrect use of the data. The Health Behaviour in School-Aged Children (HBSC) study is an international study carried out in collaboration with WHO/EURO. The international coordinator of the 1997-98, 2001-02, 2005-06, and 2009-10 surveys was Candace Currie and the databank manager for the 1997-98 survey was Bente Wold, whereas for the following surveys Oddrun Samdal was the databank manager. A list of principal investigators in each country can be found on the HBSC website. Data used in this paper come from the 2009-10 Ghana Socioeconomic Panel Study Survey, which is a nationally representative survey of more than 5000 households in Ghana. The survey is a joint effort undertaken by the Institute of Statistical, Social and Economic Research (ISSER) at the University of Ghana and the Economic Growth Centre (EGC) at Yale University. It was funded by EGC. ISSER and the EGC are not responsible for the estimations reported by the analysts. The Palestinian Central Bureau of Statistics granted the researchers access to relevant data in accordance with license number SLN2014-3-170, after subjecting data to processing aiming to preserve the confidentiality of individual data in accordance with the General Statistics Law, 2000. The researchers are solely responsible for the conclusions and inferences drawn upon available data. Data for this research was provided by MEASURE Evaluation, funded by USAID. The authors thank the Russia Longitudinal Monitoring Survey, conducted by the National Research University Higher School of Economics and ZAO Demoscope together with Carolina Population Center, University of North Carolina at Chapel Hill and the Institute of Sociology, Russia Academy of Sciences for making data available. This paper uses data from the Bhutan 2014 STEPS survey, implemented by the Ministry of Health with the support of WHO; the Kuwait 2006 and 2014 STEPS surveys, implemented by the Ministry of Health with the support of WHO; the Libya 2009 STEPS survey, implemented by the Secretariat of Health and Environment with the support of WHO; the Malawi 2009 STEPS survey, implemented by Ministry of Health with the support of WHO; and the Moldova 2013 STEPS survey, implemented by the Ministry of Health, the National Bureau of Statistics, and the National Center of Public Health with the support of WHO. This paper uses data from Survey of Health, Ageing and Retirement in Europe (SHARE) Waves 1 (DOI:10.6103/SHARE. w1.700), 2 (10.6103/SHARE.w2.700), 3 (10.6103/SHARE.w3.700), 4 (10.6103/SHARE.w4.700), 5 (10.6103/SHARE.w5.700), 6 (10.6103/SHARE.w6.700), and 7 (10.6103/SHARE.w7.700); see Borsch-Supan and colleagues (2013) for methodological details. The SHARE data collection has been funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812), FP7 (SHARE-PREP: GA N degrees 211909, SHARE-LEAP: GA N degrees 227822, SHARE M4: GA N degrees 261982) and Horizon 2020 (SHARE-DEV3: GA N degrees 676536, SERISS: GA N degrees 654221) and by DG Employment, Social Affairs & Inclusion. Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the US National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C), and from various national funding sources is gratefully acknowledged. This study has been realised using the data collected by the Swiss Household Panel, which is based at the Swiss Centre of Expertise in the Social Sciences. The project is financed by the Swiss National Science Foundation. The United States Aging, Demographics, and Memory Study is a supplement to the Health and Retirement Study (HRS), which is sponsored by the National Institute of Aging (grant number NIA U01AG009740). It was conducted jointly by Duke University and the University of Michigan. The HRS is sponsored by the National Institute on Aging (grant number NIA U01AG009740) and is conducted by the University of Michigan. This paper uses data from Add Health, a program project designed by J Richard Udry, Peter S Bearman, and Kathleen Mullan Harris, and funded by a grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 17 other agencies. Special acknowledgment is due to Ronald R Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website. No direct support was received from grant P01-HD31921 for this analysis. The data reported here have been supplied by the United States Renal Data System. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the US Government. Collection of data for the Mozambique National Survey on the Causes of Death 2007-08 was made possible by USAID under the terms of cooperative agreement GPO-A-00-08-000_D3-00. This manuscript is based on data collected and shared by the International Vaccine Institute (IVI) from an original study IVI conducted. L G Abreu acknowledges support from Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (Brazil; finance code 001) and Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq, a Brazilian funding agency). I N Ackerman was supported by a Victorian Health and Medical Research Fellowship awarded by the Victorian Government. O O Adetokunboh acknowledges the South African Department of Science and Innovation and the National Research Foundation. A Agrawal acknowledges the Wellcome Trust DBT India Alliance Senior Fellowship. S M Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. M Ausloos, C Herteliu, and A Pana acknowledge partial support by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. A Badawi is supported by the Public Health Agency of Canada. D A Bennett was supported by the NIHR Oxford Biomedical Research Centre. R Bourne acknowledges the Brien Holden Vision Institute, University of Heidelberg, Sightsavers, Fred Hollows Foundation, and Thea Foundation. G B Britton and I Moreno Velasquez were supported by the Sistema Nacional de Investigacion, SNI-SENACYT, Panama. R Buchbinder was supported by an Australian National Health and Medical Research Council (NHMRC) Senior Principal Research Fellowship. J J Carrero was supported by the Swedish Research Council (2019-01059). F Carvalho acknowledges UID/MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/MCTES through national funds. A R Chang was supported by National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases grant K23 DK106515. V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundacao para a Ciencia e Tecnologia, IP, under the Norma Transitaria DL57/2016/CP1334/CT0006. A Douiri acknowledges support and funding from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South London at King's College Hospital NHS Foundation Trust and the Royal College of Physicians, and support from the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. B B Duncan acknowledges grants from the Foundation for the Support of Research of the State of Rio Grande do Sul (IATS and PrInt) and the Brazilian Ministry of Health. H E Erskine is the recipient of an Australian NHMRC Early Career Fellowship grant (APP1137969). A J Ferrari was supported by a NHMRC Early Career Fellowship grant (APP1121516). H E Erskine and A J Ferrari are employed by and A M Mantilla-Herrera and D F Santomauro affiliated with the Queensland Centre for Mental Health Research, which receives core funding from the Queensland Department of Health. M L Ferreira holds an NHMRC Research Fellowship. C Flohr was supported by the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust. M Freitas acknowledges financial support from the EU (European Regional Development Fund [FEDER] funds through COMPETE POCI-01-0145-FEDER-029248) and National Funds (Fundacao para a Ciencia e Tecnologia) through project PTDC/NAN-MAT/29248/2017. A L S Guimaraes acknowledges support from CNPq. C Herteliu was partially supported by a grant co-funded by FEDER through Operational Competitiveness Program (project ID P_40_382). P Hoogar acknowledges Centre for Bio Cultural Studies, Directorate of Research, Manipal Academy of Higher Education and Centre for Holistic Development and Research, Kalaghatagi. F N Hugo acknowledges the Visiting Professorship, PRINT Program, CAPES Foundation, Brazil. B-F Hwang was supported by China Medical University (CMU107-Z-04), Taichung, Taiwan. S M S Islam was funded by a National Heart Foundation Senior Research Fellowship and supported by Deakin University. R Q Ivers was supported by a research fellowship from the National Health and Medical Research Council of Australia. M Jakovljevic acknowledges the Serbian part of this GBD-related contribution was co-funded through Grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. P Jeemon was supported by a Clinical and Public Health intermediate fellowship (grant number IA/CPHI/14/1/501497) from the Wellcome Trust-Department of Biotechnology, India Alliance (2015-20). O John is a recipient of UIPA scholarship from University of New South Wales, Sydney. S V Katikireddi acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_12017/13, MC_UU_12017/15), and the Scottish Government Chief Scientist Office (SPHSU13, SPHSU15). C Kieling is a CNPq researcher and a UK Academy of Medical Sciences Newton Advanced Fellow. Y J Kim was supported by Research Management Office, Xiamen University Malaysia (XMUMRF/2018-C2/ITCM/00010). K Krishan is supported by UGC Centre of Advanced Study awarded to the Department of Anthropology, Panjab University, Chandigarh, India. M Kumar was supported by K43 TW 010716 FIC/NIMH. B Lacey acknowledges support from the NIHR Oxford Biomedical Research Centre and the BHF Centre of Research Excellence, Oxford. J V Lazarus was supported by a Spanish Ministry of Science, Innovation and Universities Miguel Servet grant (Instituto de Salud Carlos III [ISCIII]/ESF, the EU [CP18/00074]). K J Looker thanks the NIHR Health Protection Research Unit in Evaluation of Interventions at the University of Bristol, in partnership with Public Health England, for research support. S Lorkowski was funded by the German Federal Ministry of Education and Research (nutriCARD, grant agreement number 01EA1808A). R A Lyons is supported by Health Data Research UK (HDR-9006), which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, NIHR (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation, and Wellcome Trust. J J McGrath is supported by the Danish National Research Foundation (Niels Bohr Professorship), and the Queensland Health Department (via West Moreton HHS). P T N Memiah acknowledges support from CODESRIA. U O Mueller gratefully acknowledges funding by the German National Cohort Study BMBF grant number 01ER1801D. S Nomura acknowledges the Ministry of Education, Culture, Sports, Science, and Technology of Japan (18K10082). A Ortiz was supported by ISCIII PI19/00815, DTS18/00032, ISCIII-RETIC REDinREN RD016/0009 Fondos FEDER, FRIAT, Comunidad de Madrid B2017/BMD-3686 CIFRA2-CM. These funding sources had no role in the writing of the manuscript or the decision to submit it for publication. S B Patten was supported by the Cuthbertson & Fischer Chair in Pediatric Mental Health at the University of Calgary. G C Patton was supported by an aNHMRC Senior Principal Research Fellowship. M R Phillips was supported in part by the National Natural Science Foundation of China (NSFC, number 81371502 and 81761128031). A Raggi, D Sattin, and S Schiavolin were supported by grants from the Italian Ministry of Health (Ricerca Corrente, Fondazione Istituto Neurologico C Besta, Linea 4-Outcome Research: dagli Indicatori alle Raccomandazioni Cliniche). P Rathi and B Unnikrishnan acknowledge Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal. A L P Ribeiro was supported by Brazilian National Research Council, CNPq, and the Minas Gerais State Research Agency, FAPEMIG. D C Ribeiro was supported by The Sir Charles Hercus Health Research Fellowship (#18/111) Health Research Council of New Zealand. D Ribeiro acknowledges financial support from the EU (FEDER funds through the Operational Competitiveness Program; POCI-01-0145-FEDER-029253). P S Sachdev acknowledges funding from the NHMRC of Australia Program Grant. A M Samy was supported by a fellowship from the Egyptian Fulbright Mission Program. M M Santric-Milicevic acknowledges the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract number 175087). R Sarmiento-Suarez received institutional support from Applied and Environmental Sciences University (Bogota, Colombia) and ISCIII (Madrid, Spain). A E Schutte received support from the South African National Research Foundation SARChI Initiative (GUN 86895) and Medical Research Council. S T S Skou is currently funded by a grant from Region Zealand (Exercise First) and a grant from the European Research Council under the EU's Horizon 2020 research and innovation program (grant agreement number 801790). J B Soriano is funded by Centro de Investigacion en Red de Enfermedades Respiratorias, ISCIII. R Tabares-Seisdedos was supported in part by the national grant PI17/00719 from ISCIII-FEDER. N Taveira was partially supported by the European & Developing Countries Clinical Trials Partnership, the EU (LIFE project, reference RIA2016MC-1615). S Tyrovolas was supported by the Foundation for Education and European Culture, the Sara Borrell postdoctoral programme (reference number CD15/00019 from ISCIII-FEDER). S B Zaman received a scholarship from the Australian Government research training programme in support of his academic career., "Peer Reviewed"
Published: 2020

19. List of Contributors

Author: Leslie Abrams-Tobe, Samer A Abuswider, Jorge Acosta, Pavi Agrawal, Oscar Albis-Donado, Luciana M Alencar, R Rand Allingham, Annahita Amireskandari, Nitin Anand, Florent Aptel, Makoto Araie, Enyr S Arcieri, Ehud I Assia, Tin Aung, George Baerveldt, Nafees Baig, Annie K Baik, Rajendra K Bansal, Mirko Babic, Anita Barikian, Howard Barnebey, Keith Barton, Christophe Baudouin, Allen Beck, Sonya L Bennett, Stanley J Berke, Tui H Bevin, Shibal Bhartiya, Philip A Bloom, Dana M Blumberg, Kathryn Bollinger, Christopher Bowd, John W Boyle, James D Brandt, David C Broadway, Stephen Brocchini, Alain M Bron, Donald L Budenz, Catey Bunce, Claude F Burgoyne, Jennifer Burr, Yvonne M Buys, Louis B Cantor, Joseph Caprioli, Roberto G Carassa, Daniel S Casper, Yara Paula Catoira-Boyle, Piero Ceruti, Debasis Chakrabarti, Raka Chakrabarti, Pratap Challa, Errol Chan, Peter T Chang, Robert T Chang, Balwantray C Chauhan, Aiyin Chen, Jason Cheng, Paul TK Chew, Mark Chiang, Etsuo Chihara, Neil T Choplin, George A Cioffi, Colin I Clement, Anne L Coleman, Nathan G Congdon, Michael A Coote, Vital P Costa, David P Crabb, Alan S Crandall, E Randy Craven, Laura Crawley, Jonathan G Crowston, Emmett T Cunningham, Elie Dahan, Annegret H Dahlmann-Noor, Karim F Damji, Alexander Day, Me'Ja Day, Philippe Denis, Syril Dorairaj, J Crawford Downs, Gordon N Dutton, Hassan Eldaly, Fathi F El Sayyad, Benedetto Falsini, Francisco Fantes, Herbert P Fechter, Robert D Fechtner, Ronald L Fellman, Eva Fenwick, Arosha Fernando, Ann Caroline Fisher, Frederick W Fitzke, Brad Fortune, Paul Foster, Panayiota Founti, Jeffrey Freedman, Stefano A Gandolfi, Julián García-Feijoó, David Garway-Heath, Gus Gazzard, Steven J Gedde, Noa Geffen, Stelios Georgoulas, Annette Giangiacomo, Katie Gill, Zisis Gkatzioufas, Ivan Goldberg, Pieter Gouws, Stuart L Graham, Alana L Grajewski, David S Greenfield, Franz Grehn, Daniel E Grigera, Ronald L Gross, Davinder S Grover, Rafael Grytz, Meenakashi Gupta, Neeru Gupta, Carlos Gustavo de Moraes, Ali S Hafez, Farhad Hafezi, Teruhiko Hamanaka, Alon Harris, Marcelo Hatanaka, Matthew J Hawker, Paul R Healey, The late Catherine J Heatley, Dale K Heuer, Eve J Higginbotham, Cornelia Hirn, Roger A Hitchings, Gábor Holló, Ann M Hoste, Andrew Huck, Cindy ML Hutnik, Camille Hylton, Sabita M Ittoop, Farrah Ja'afar, Henry Jampel, Thomas V Johnson, Jost B Jonas, Malik Y Kahook, Michael A Kass, Andreas Katsanos, L Jay Katz, Jill E Keeffe, Thomas Kersey, Naira Khachatryan, Sir Peng Tee Khaw, Albert S Khouri, Dan Kiage, Lee Kiang, Danny Kim, Yoshiaki Kiuchi, Thomas Klink, Helen Koenigsman, Anastasios GP Konstas, Aachal Kotecha, Avinash Kulkarni, Alexander V Kuroyedov, Antoine Labbé, Alan Lacey, Dennis SC Lam, Ecosse L Lamourex, Graham Lee, Paul Lee, Hans G Lemij, Anthony Leoncavallo, Mark R Lesk, Christopher KS Leung, Dexter YL Leung, Leonard A Levin, Richard A Lewis, K Sheng Lim, Ridia Lim, Ricardo de Lima, Yutao Liu, Alastair Lockwood, Sancy Low, Fumihiko Mabuchi, David A Mackey, Rizwan Malik, Anil K Mandal, Steven L Mansberger, Kaweh Mansouri, Giorgio Marchini, Manjula Marella, Keith R Martin, Robert H McGlynn, Steven H McKinley, Stuart J McKinnon, J Ryan McManus, Felipe A Medeiros, André Mermoud, Clive S Migdal, Don Minckler, Anthony CB Molteno, Paolo Mora, Javier Moreno-Montañés, James E Morgan, Sameh Mosaed, Marilita M Moschos, Kelly W Muir, Gonzalo Muñoz, Francisco J Muñoz-Negrete, Arvind Neelakantan, Anil K Negi, Peter A Netland, Paula Anne Newman-Casey, Marcelo T Nicolela, Nuwan Niyadurupola, Magdy A Nofal, Winnie Nolan, Monisha E Nongpiur, Baha'a N Noureddin, Gary D Novack, Brenda Nuyen, Krishnamurthy Palaniswamy, Camille Palma, Ki Ho Park, Richard K Parrish, Maria Papadopoulos, Rajul S Parikh, Louis R Pasquale, Alice Pébay, Sergey Petrov, Jody Piltz-Seymour, Luís Abegão Pinto, Ian F Pitha, Norbert Pfeiffer, Luciano Quaranta, Pradeep Y Ramulu, Emilie Ravinet, Tony Realini, Gema Rebolleda, Nic J Reus, Adam C Reynolds, Douglas J Rhee, Isabelle Riss, Robert Ritch, Charles E Riva, Gloria Roberti, Cynthia J Roberts, Alan L Robin, Prin Rojanapongpun, Sylvain Roy, John F Salmon, Juan Roberto Sampaolesi, Chiara Sangermani, Usman A Sarodia, Jamie Lea Schaefer, Ursula Schloetzer-Schrehardt, Gregory S Schultz, Joel S Schuman, Leonard K Seibold, Tarek M Shaarawy, Peter Shah, Mark B Sherwood, Lineu Oto Shiroma, Brent Siesky, Sergio Estrela Silva, Annapurna Singh, Arun D Singh, Kuldev Singh, Chelvin CA Sng, Brian J Song, George L Spaeth, Alexander Spratt, Ingeborg Stalmans, Robert L Stamper, Kazuhisa Sugiyama, Remo Susanna, Orathai Suwanpimolkul, William H Swanson, Ernst R Tamm, Tak Yee Tania Tai, Angelo P Tanna, Chaiwat Teekhasaenee, Clement CY Tham, Hagen Thieme, Ravi Thomas, Andrew M Thompson, Ravilla D Thulasiraj, John Thygesen, Karim Tomey, Yokrat Ton, Fotis Topouzis, Carol B Toris, Roberto Tosi, James C Tsai, Sonal S Tuli, Anja Tuulonen, Nicola Ungaro, Luke Vale, Leonieke ME van Koolwijk, Reena S Vaswani, Rengaraj Venkatesh, Cristina Venturini, Stephen A Vernon, Eranga N Vithana, Lingam Vijaya, Ananth C Viswanathan, Gabriele Vizzari, Irini C Voudouragkaki, Michael Waisbourd, Mark J Walland, Robert N Weinreb, Mark Werner, Anthony Wells, Boateng Wiafe, Jacob Wilensky, Tina T Wong, Darrell WuDunn, Jennifer LY Yip, Yeni Yucel, Linda M Zangwill, Virginia E Zanutigh, Joseph R Zelefsky, and Thierry Zeyen
Published: 2015

20. Cerebrospinal fluid pressure in the pathogenesis of glaucoma

Author: Robert Ritch, Jost B. Jonas, and Songhomitra Panda-Jonas
Subjects: Intraocular pressure, medicine.medical_specialty, genetic structures, Open angle glaucoma, business.industry, Glaucoma, medicine.disease, eye diseases, Surgery, Blood pressure, medicine.anatomical_structure, Ophthalmology, Optic nerve, medicine, sense organs, Cerebrospinal fluid pressure, Choroid, medicine.symptom, Papilledema, business
Abstract: The optic nerve head forms the interface between the intraocular compartment and the retrobulbar compartment. The former is characterized by what we term intraocular pressure (IOP) and the latter by orbital cerebrospinal fluid pressure (CSFP). The trans-lamina cribrosa pressure difference (TLCPD) is defined as the difference between the pressures in the two compartments. Any change in one of them can be associated with a disturbance of homeostasis of the optic nerve head, such as papilledema or glaucomatous optic neuropathy. In particular, glaucomatous optic neuropathy may be due to either an elevated IOP and/or an abnormally low orbital CSFP, or due to a change in the time-dependent relationship between the pulse-synchronous changes in IOP and orbital CSFP. Based on the triangular relationships between IOP, CSFP, and blood pressure, glaucoma may be described as an imbalance between these three pressure parameters, eventually leading to an increased TLCPD. Because the retinal and choroidal venous blood drains through the CSFP space, elevated CSFP may be associated with dilated retinal veins, increased incidence of retinal vein occlusions, higher prevalence and severity of diabetic retinopathy, and thicker choroid.
Published: 2015

21. Optic Disc Photography in the Diagnosis of Glaucoma

Author: Jost B. Jonas, Alain M. Bron, University Hospital Center Mannheim, Partenaires INRAE, Centre des Sciences du Goût et de l'Alimentation (CSGA), Institut National de la Recherche Agronomique (INRA)-Université de Bourgogne (UB)-Centre National de la Recherche Scientifique (CNRS), and Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)
Subjects: medicine.medical_specialty, business.industry, Photography, Glaucoma, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Ophthalmology, 030221 ophthalmology & optometry, Medicine, [SDV.MHEP.OS]Life Sciences [q-bio]/Human health and pathology/Sensory Organs, business, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, 030217 neurology & neurosurgery, Optic disc
Abstract: International audience
Published: 2015

22. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

Author: Karen Sliwa, Xiaofeng Liang, Vivekanand Jha, Dorairaj Prabhakaran, Rakhi Dandona, Gonghuan Yang, Xuan Che, Soewarta Kosen, Sergei Petrovich Ermakov, Ted R. Miller, Samath D Dharmaratne, Philimon Gona, Sergey Soshnikov, Atsushi Goto, Costas A. Christophi, Zacharie Tsala Dimbuene, Elena Alvarez, Yanping Wang, Peggy Pei-Chia Chiang, Mohammad H. Forouzanfar, Giancarlo Logroscino, Massimo Cirillo, Knud Juel, Johanna M. Geleijnse, Stefan Ma, Samaya Ismayilova, Karen Fern Greenwell, Michelle L. Bell, Saad B. Omer, Ademola Lukman Adelekan, Joshua A. Salomon, Dhruv S. Kazi, Jed D. Blore, Walid Ammar, Carly E Levitz, Kovin Naidoo, Solveig A. Cunningham, Stephen G. Waller, Anand Dayama, James D. Wilkinson, Vasiliki Stathopoulou, Meghan D. Mooney, Mall Leinsalu, Jonathan R. Carapetis, Paul S. F. Yip, Anders Larsson, Abbas Ali Mahdi, Hideaki Toyoshima, Guohong Jiang, Xia Wan, Chuanhua Yu, Soufiane Boufous, Ivy Shiue, Bulat Idrisov, Qing Lan, Chelsea A. Liddell, Austin E Schumacher, Valeria Caso, Nigel Bruce, Paulo A. Lotufo, Ibrahim Abubakar, Roberto Tchio Talongwa, Luke Nyakarahuka, Edward J Mills, Iuri da Costa Leite, Semaw Ferede Abera, Ana C. Garcia, Ayse Abbasoglu Ozgoren, Matthew M Coates, Konstantinos Stroumpoulis, Bradford D. Gessner, Kebede Deribe, Tommi Vasankari, Logan Sandar, Kenji Shibuya, Karen M. Tabb, Troy Jacobs, Christopher J L Murray, Chakib Nejjari, Katherine T. Lofgren, Melvin Barrientos Marzan, Haidong Wang, Joanna Moschandreas, Raimundas Lunevicius, Nataliya Foigt, Rashmi Gupta, Ziad A. Memish, Victoria Pillay-van Wyk, Randah R. Hamadeh, Azmeraw T. Amare, Lalit Dandona, Uchechukwu K.A. Sampson, Monika Sawhney, Vasiliy Victorovich Vlassov, Farhad Islami, Palwasha Anwari, Mustafa Z. Younis, Amitava Banerjee, Ruben Castro, David O. Carpenter, Karzan Abdulmuhsin Mohammad, Taavi Lai, Yousef Khader, Sara Sheikhbahaei, Atte Meretoja, Zanfina Ademi, Ivo Rakovac, Yang Yang, Hilda L Harb, Daniel Pope, Jun She, Yichong Li, Andrew L. Thorne-Lyman, Adrian Davis, Stein Emil Vollset, Andre Pascal Kengne, Henry Apfel, Mark J. Nieuwenhuijsen, John J. McGrath, Yoshihiro Kokubo, Jonas Minet Kinge, Elisabete Weiderpass, Rajiv Chowdhury, Damian G Hoy, Jürgen C Schmidt, Seyed-Mohammad Fereshtehnejad, Harish Chander Gugnani, Hywel C Williams, Karen Edmond, Peter J. Allen, Marina Shakh-Nazarova, Tom Achoki, Edmond K. Kabagambe, Naohiro Yonemoto, Jun Zhu, Simon I. Hay, Karen J. Courville, Ketevan Goginashvili, Theo Vos, Kim Yun Jin, Kawkab Shishani, Lorenzo Monasta, H. Dean Hosgood, Uʇur Dilmen, Marcella Montico, Shankuan Zhu, Ami R. Moore, Marie Ng, Maigeng Zhou, Hebe N. Gouda, Linh N Bui, Sanjay Basu, Mouhanad Hammami, Mohammad T Mashal, Bryan K. Phillips, Marissa Iannarone, Ronan A Lyons, Young-Ho Khang, Robert G. Weintraub, Luca Ronfani, Daniel Kim, Alanur Çavlin, Ferrán Catalá-López, Ronny Westerman, Maia Kereselidze, Itamar S. Santos, Reza Assadi, Hwashin Hyun Shin, Carolina Maria Teixeira, Berrak Bora Basara, David Rojas-Rueda, Abdullah Sulieman Terkawi, Adansi A. Amankwaa, Nicholas J K Breitborde, Gokalp Kadri Yentur, Kaushalendra Kumar, Daniel Obadare Fijabi, Neeraj Bedi, Robert Quentin Reilly, Ana Maria Nogales Vasconcelos, Scott Weichenthal, Mark A. Green, Selen Begüm Uzun, Mukesh Dherani, Shams Eldin Ali Hassan Khalifa, Majed Asad, Jasvinder A. Singh, Angel J Paternina Caicedo, Eric L. Ding, Jost B. Jonas, Tolesa Bekele, Alan J Thomson, Steven E. Lipshultz, Rosario Cárdenas, Sajjad Ur Rahman, George A. Mensah, Jongmin Lee, Inga Dora Sigfusdottir, Mohammad Yahya Saeedi, Magdalena M. Muszyńska, Ulrich O Mueller, Stephen S Lim, Barthelemy Kuate Defo, Alan D. Lopez, Luciano A. Sposato, G Anil Kumar, Farshad Pourmalek, Zulfiqar A Bhutta, Maysaa El Sayed Zaki, Shiwei Liu, K.M. Venkat Narayan, William Msemburi, Ting Wu Chuang, Zewdie Aderaw Alemu, Saleem M Rana, Mohammad Taghi Hedayati, Mohsen Naghavi, Vegard Skirbekk, Walter Mendoza, Ali H. Mokdad, Yohannes Kinfu, Jean de Dieu Ngirabega, Takayoshi Ohkubo, Parfait Uwaliraye, Tasara T. Mazorodze, Farshad Farzadfar, Rob E. Dorrington, Mohammad A. AlMazroa, R. Kumar, Lesley Rushton, Wang, H, Liddell, Ca, Coates, Mm, Mooney, Md, Levitz, Ce, Schumacher, Ae, Apfel, H, Iannarone, M, Phillips, B, Lofgren, Kt, Sandar, L, Dorrington, Re, Rakovac, I, Jacobs, Ta, Liang, X, Zhou, M, Zhu, J, Yang, G, Wang, Y, Liu, S, Li, Y, Ozgoren, Aa, Abera, Sf, Abubakar, I, Achoki, T, Adelekan, A, Ademi, Z, Alemu, Za, Allen, Pj, Almazroa, Ma, Alvarez, E, Amankwaa, Aa, Amare, At, Ammar, W, Anwari, P, Cunningham, Sa, Asad, Mm, Assadi, R, Banerjee, A, Basu, S, Bedi, N, Bekele, T, Bell, Ml, Bhutta, Z, Blore, J, Basara, Bb, Boufous, S, Breitborde, N, Bruce, Ng, Bui, Ln, Carapetis, Jr, Cárdenas, R, Carpenter, Do, Caso, V, Castro, Re, Catalá Lopéz, F, Cavlin, A, Che, X, Chiang, Pp, Chowdhury, R, Christophi, Ca, Chuang, Tw, Cirillo, Massimo, da Costa Leite, I, Courville, Kj, Dandona, L, Dandona, R, Davis, A, Dayama, A, Deribe, K, Dharmaratne, Sd, Dherani, Mk, Dilmen, U, Ding, El, Edmond, Km, Ermakov, Sp, Farzadfar, F, Fereshtehnejad, Sm, Fijabi, Do, Foigt, N, Forouzanfar, Mh, Garcia, Ac, Geleijnse, Jm, Gessner, Bd, Goginashvili, K, Gona, P, Goto, A, Gouda, Hn, Green, Ma, Greenwell, Kf, Gugnani, Hc, Gupta, R, Hamadeh, Rr, Hammami, M, Harb, Hl, Hay, S, Hedayati, Mt, Hosgood, Hd, Hoy, Dg, Idrisov, Bt, Islami, F, Ismayilova, S, Jha, V, Jiang, G, Jonas, Jb, Juel, K, Kabagambe, Ek, Kazi, D, Kengne, Ap, Kereselidze, M, Khader, Y, Khalifa, Se, Khang, Yh, Kim, D, Kinfu, Y, Kinge, Jm, Kokubo, Y, Kosen, S, Defo, Bk, Kumar, Ga, Kumar, K, Kumar, Rb, Lai, T, Lan, Q, Larsson, A, Lee, Jt, Leinsalu, M, Lim, S, Lipshultz, Se, Logroscino, G, Lotufo, Pa, Lunevicius, R, Lyons, Ra, Ma, S, Mahdi, Aa, Marzan, Mb, Mashal, Mt, Mazorodze, Tt, Mcgrath, Jj, Memish, Za, Mendoza, W, Mensah, Ga, Meretoja, A, Miller, Tr, Mills, Ej, Mohammad, Ka, Mokdad, Ah, Monasta, L, Montico, M, Moore, Ar, Moschandreas, J, Msemburi, Wt, Mueller, Uo, Muszynska, Mm, Naghavi, M, Naidoo, K, Narayan, Kv, Nejjari, C, Ng, M, de Dieu Ngirabega, J, Nieuwenhuijsen, Mj, Nyakarahuka, L, Ohkubo, T, Omer, Sb, Caicedo, Aj, Wyk, Vp, Pope, D, Prabhakaran, D, Rahman, Su, Rana, Sm, Reilly, Rq, Rojas Rueda, D, Ronfani, L, Rushton, L, Saeedi, My, Salomon, J, Sampson, U, Santos, I, Sawhney, M, Schmidt, Jc, Shakh Nazarova, M, She, J, Sheikhbahaei, S, Shibuya, K, Shin, Hh, Shishani, K, Shiue, I, Sigfusdottir, Id, Singh, Ja, Skirbekk, V, Sliwa, K, Soshnikov, S, Sposato, La, Stathopoulou, Vk, Stroumpoulis, K, Tabb, Km, Talongwa, Rt, Teixeira, Cm, Terkawi, A, Thomson, Aj, Thorne Lyman, Al, Toyoshima, H, Dimbuene, Zt, Uwaliraye, P, Uzun, Sb, Vasankari, Tj, Vasconcelos, Am, Vlassov, Vv, Vollset, Se, Vos, T, Waller, S, Wan, X, Weichenthal, S, Weiderpass, E, Weintraub, Rg, Westerman, R, Wilkinson, Jd, Williams, Hc, Yang, Yc, Yentur, Gk, Yip, P, Yonemoto, N, Younis, M, Yu, C, Jin, Ky, El Sayed Zaki, M, Zhu, S, Lopez, Ad, and Murray, C. J.
Subjects: trends, Pediatrics, medicine.medical_specialty, Nutrition and Disease, democracy, Developing country, coverage, VDP::Medisinske fag: 700::Helsefag: 800::Epidemiologi medisinsk og odontologisk statistikk: 803, millennium development goals, Global Health, survival, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, 030225 pediatrics, Voeding en Ziekte, Infant Mortality, Global health, Humans, Organizational Objectives, Medicine, 030212 general & internal medicine, 10. No inequality, VLAG, business.industry, Mortality rate, Infant, Newborn, 1. No poverty, Infant, health, General Medicine, Millennium Development Goals, Infant mortality, maternal education, 3. Good health, Secular variation, Child mortality, Socioeconomic Factors, income countries, Child, Preschool, Child Mortality, developing-countries, VDP::Midical sciences: 700::Health sciences: 800::Epidemiology, medical and dental statistics: 803, International development, business, Demography, child-mortality
Abstract: Summary Background Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015, and to identify models of success. Methods We generated updated estimates of child mortality in early neonatal (age 0–6 days), late neonatal (7–28 days), postneonatal (29–364 days), childhood (1–4 years), and under-5 (0–4 years) age groups for 188 countries from 1970 to 2013, with more than 29 000 survey, census, vital registration, and sample registration datapoints. We used Gaussian process regression with adjustments for bias and non-sampling error to synthesise the data for under-5 mortality for each country, and a separate model to estimate mortality for more detailed age groups. We used explanatory mixed effects regression models to assess the association between under-5 mortality and income per person, maternal education, HIV child death rates, secular shifts, and other factors. To quantify the contribution of these different factors and birth numbers to the change in numbers of deaths in under-5 age groups from 1990 to 2013, we used Shapley decomposition. We used estimated rates of change between 2000 and 2013 to construct under-5 mortality rate scenarios out to 2030. Findings We estimated that 6·3 million (95% UI 6·0–6·6) children under-5 died in 2013, a 64% reduction from 17·6 million (17·1–18·1) in 1970. In 2013, child mortality rates ranged from 152·5 per 1000 livebirths (130·6–177·4) in Guinea-Bissau to 2·3 (1·8–2·9) per 1000 in Singapore. The annualised rates of change from 1990 to 2013 ranged from −6·8% to 0·1%. 99 of 188 countries, including 43 of 48 countries in sub-Saharan Africa, had faster decreases in child mortality during 2000–13 than during 1990–2000. In 2013, neonatal deaths accounted for 41·6% of under-5 deaths compared with 37·4% in 1990. Compared with 1990, in 2013, rising numbers of births, especially in sub-Saharan Africa, led to 1·4 million more child deaths, and rising income per person and maternal education led to 0·9 million and 2·2 million fewer deaths, respectively. Changes in secular trends led to 4·2 million fewer deaths. Unexplained factors accounted for only −1% of the change in child deaths. In 30 developing countries, decreases since 2000 have been faster than predicted attributable to income, education, and secular shift alone. Interpretation Only 27 developing countries are expected to achieve MDG 4. Decreases since 2000 in under-5 mortality rates are accelerating in many developing countries, especially in sub-Saharan Africa. The Millennium Declaration and increased development assistance for health might have been a factor in faster decreases in some developing countries. Without further accelerated progress, many countries in west and central Africa will still have high levels of under-5 mortality in 2030. Funding Bill & Melinda Gates Foundation, US Agency for International Development.
Published: 2014

23. Causes of vision loss worldwide, 1990–2010: a systematic analysis

Author: Rupert R A Bourne, Seth Flaxman, Gretchen A Stevens, Jill E Keeffe, Jennifer L. Smith, Serge Resnikoff, Kovin Naidoo, Janet L Leasher, Jost B. Jonas, Hugh R. Taylor, Holly Price, Konrad Pesudovs, and Richard A. White
Subjects: Male, visual impairment, global data, prevalence, blindness, population, rotterdam, glaucoma, eye, Refractive error, Visual acuity, genetic structures, Population, Visual impairment, Vision Disorders, Glaucoma, Blindness, Global Health, Cataract, Macular Degeneration, medicine, Humans, education, Trachoma, education.field_of_study, Diabetic Retinopathy, business.industry, lcsh:Public aspects of medicine, lcsh:RA1-1270, General Medicine, Diabetic retinopathy, Macular degeneration, medicine.disease, eye diseases, Optometry, Female, sense organs, medicine.symptom, business
Abstract: Summary Background Data on causes of vision impairment and blindness are important for development of public health policies, but comprehensive analysis of change in prevalence over time is lacking. Methods We did a systematic analysis of published and unpublished data on the causes of blindness (visual acuity in the better eye less than 3/60) and moderate and severe vision impairment ([MSVI] visual acuity in the better eye less than 6/18 but at least 3/60) from 1980 to 2012. We estimated the proportions of overall vision impairment attributable to cataract, glaucoma, macular degeneration, diabetic retinopathy, trachoma, and uncorrected refractive error in 1990–2010 by age, geographical region, and year. Findings In 2010, 65% (95% uncertainty interval [UI] 61–68) of 32·4 million blind people and 76% (73–79) of 191 million people with MSVI worldwide had a preventable or treatable cause, compared with 68% (95% UI 65–70) of 31·8 million and 80% (78–83) of 172 million in 1990. Leading causes worldwide in 1990 and 2010 for blindness were cataract (39% and 33%, respectively), uncorrected refractive error (20% and 21%), and macular degeneration (5% and 7%), and for MSVI were uncorrected refractive error (51% and 53%), cataract (26% and 18%), and macular degeneration (2% and 3%). Causes of blindness varied substantially by region. Worldwide and in all regions more women than men were blind or had MSVI due to cataract and macular degeneration. Interpretation The differences and temporal changes we found in causes of blindness and MSVI have implications for planning and resource allocation in eye care. Funding Bill & Melinda Gates Foundation, Fight for Sight, Fred Hollows Foundation, and Brien Holden Vision Institute.
Published: 2013

24. Posterior Eye Shape in Myopia

Author: Jost B. Jonas, MD, Songhomitra Panda-Jonas, MD, Zhe Pan, MD, Jie Xu, MD, and Ya Xing Wang, MD
Subjects: Axial elongation, Beijing Eye Study, Dome-shaped macula, High myopia, Macular ridges, Ophthalmology, RE1-994
Abstract: Purpose: To explore prevalence and associated factors of abnormalities of the posterior eye shape in dependence of axial length. Design: Population-based study. Participants: Of the participants (n = 3468) of the Beijing Eye Study, we included all eyes with an axial length of ≥25 mm, and a randomized sample of eyes with an axial length of
Published: 2024
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25. Unintentional injuries and falls in populations in Russia. The Ural eye and medical study and the Ural very old study

Author: Mukharram M. Bikbov, Gyulli M. Kazakbaeva, Timur R. Gilmanshin, Rinat M. Zainullin, Ellina M. Iakupova, Songhomitra Panda-Jonas, Albina A. Fakhretdinova, Azaliia M. Tuliakova, Leisan I. Gilemzianova, Dinar A. Khakimov, Liana A. Miniazeva, and Jost B. Jonas
Subjects: Unintentional injuries, Falls, Depression, Anxiety, Vision impairment, Hearing impairment, Science (General), Q1-390, Social sciences (General), H1-99
Abstract: Background: To explore the prevalence of self-reported unintentional injuries and falls (UIFs) in medium-aged and old populations in Russia and factors associated with them. Methods: Two population-based studies (Ural Eye and Medical Study (UEMS), Ural Very Old Study (UVOS)) were carried out urban and rural areas in Bashkortostan/Russia. They consisted of 5899 individuals (age: 40+ years) and 1526 participants (age: 85+ years), respectively. We assessed previous falls as part of an interview with standardized questions, conducted in the framework of a series medical and ophthalmological assessments. Results: In the UEMS with 5894 individuals (age:59.0 ± 10.7 years), UIF prevalence was 1101/5894 (18.7 %; 95 % confidence interval (CI)CI:17.7,19.7), with 1,2,3,4,5,6,7,8,9, or 10+ UIFs reported by 766 (69.6 %),146 (13.3 %),56 (1.4 %),15 (1.4 %),19 (1.7 %),3 (0.3 %),2 (0.2 %),1 (0.01 %), and 10 (0.9 %) participants, respectively. The UIFs had occurred as outdoor incidents (n = 594; 53.8 %), at home (n = 162; 14.7 %), on the road or traffic accidents (n = 109; 9.9 %), at work (n = 77; 7.0 %), during garden work (n = 24; 2.2 %) or as falls from a higher level (n = 17; 1.5 %) or from house roofs (n = 16; 1.4 %). In 100 (1.7 % of the total study population; 9.1 % of the group with UIFs) participants, low vision was reported as a major cause for the UIF. Higher UIF prevalence was associated (multivariable analysis) with older age (odds ratio (OR):1.01; 95%CI:1.005,1.02;P
Published: 2024
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26. Intraocular pressure and its determinants in a very old population. The ural very old study

Author: Mukharram M. Bikbov, Gyulli M. Kazakbaeva, Ellina M. Rakhimova, Songhomitra Panda-Jonas, Azaliia M. Tuliakova, Albina A. Fakhretdinova, Iulia A. Rusakova, and Jost B. Jonas
Subjects: Intraocular pressure, Central corneal thickness, Axial length, Myopia, Cerebrospinal fluid pressure, Arterial blood pressure, Science (General), Q1-390, Social sciences (General), H1-99
Abstract: Purpose: To explore intraocular pressure (IOP) and its associated parameters in an aged population. Methods: The epidemiologic Ural Very Old Study (UVOS) conducted in Bashkortostan/Russia included 1526 participants with an age of ≥85 years. Besides a whole series of ocular and systemic examinations, IOP was determined applying non-contact tonometry. Body mass index, diastolic blood pressure and age were the factors used to estimate the cerebrospinal fluid pressure (CSFP). Results: The study consisted of 904 participants (age: 88.6 ± 2.7 years) with available IOP readings and without anti-glaucomatous therapy. Mean IOP was 14.5 ± 5.1 mmHg (median: 14 mm Hg; Q1:11; Q3:16; 95%CI:8,25) and 14.8 ± 4.6 mmHg (median: 14 mm Hg; Q1:12; Q3:17; 95%CI:8,28) in the right and left eyes, respectively. Higher IOP correlated (multivariable analysis; correlation coefficient r2:0.32) with female sex (P
Published: 2024
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27. Intraretinal Retinal Pigment Epithelium Cells in Age-Related Macular Degeneration

Author: Songhomitra Panda-Jonas, MD, Rahul A. Jonas, MD, Jie Xu, MD, Ya Xing Wang, MD, and Jost B. Jonas, MD
Subjects: Age-related macular degeneration, Drusen, Retinal microglial cells, Retinal photoreceptors, Retinal pigment epithelium, Ophthalmology, RE1-994
Abstract: Purpose: To examine intraretinally migrated retinal pigment epithelium cells (iRPECs) in enucleated human eyes with various retinal conditions and corresponding intraretinal hyperreflective bodies (iHRBs) in a large cohort of patients with age-related macular degeneration (AMD) in China. Design: Population-based study and histomorphometric investigation. Participants: Participants of the population-based Beijing Eye Study and enucleated human eyes. Methods: OCT-based and fundus photography-based examination of the macula of the Beijing Eye Study participants and light-microscopical histomorphometry of enucleated human eyes. Main Outcome Measures: Presence and location of iRPECs and iHRBs. Results: In the Beijing Eye Study (6551 eyes; 3301 participants), the prevalence of intermediate AMD and late AMD was 331 (5.1%) and 44 (0.6%), respectively. All 42 eyes with intermediate AMD and macular hyperpigmentation had iHRBs at locations corresponding spatially with macular hyperpigmentation on the fundus photographs. Among all eyes with intermediate AMD (n = 331), iHRBs were detected in 262 (79.2%) eyes. The most internal location of the iHRBs was at the ellipsoid zone in 46 (13.9%) eyes, at the external limiting membrane (ELM) in 45 (13.6%) eyes, and in the outer nuclear layer in 145 (43.8%) eyes. Out of the 262 eyes with iHRBs, 186 (71.0%) eyes showed a corresponding defect in the ellipsoid zone, and 128 (48.9%) eyes showed a defect in the ELM. The eyes with an iHRB located beneath the ELM did not show an ELM defect. The iHRBs were associated with a plume-like appearance and with a smoke-like appearance in 20 (7.6%) eyes and 137 (52.3%) eyes, respectively. All iHRBs did not have a shadow on the OCT images. Similar findings were obtained in the eyes with late AMD. Among 237 eyes examined histologically, 21 globes showed iRPECs: 8 eyes in parapapillary α zone/β zone; 5 eyes with myopic patchy atrophies, and 3 eyes with AMD. The iRPECs were spatially associated with an ELM defect and were not surrounded by a basal membrane. Conclusions: Intraretinal hyperreflective bodies can be found in 3 out of 4 eyes with intermediate AMD, correlate histologically with intraretinally located (migrated) retinal pigment epithelium cells, and correspond spatially with localized defects of the ellipsoid zone and ELM. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Published: 2025
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28. Anterior chamber depth and angle and associations in a pediatric and adult population in Russia

Author: Mukharram M. Bikbov, Gyulli M. Kazakbaeva, Ellina M. Iakupova, Timur R. Gilmanshin, Albina A. Fakhretdinova, Azaliia M. Tuliakova, Songhomitra Panda-Jonas, Liana A. Miniazeva, Leisan I. Gilemzianova, Dinar A. Khakimov, Iuliia A. Rusakova, Liaisan I. Islamova, Nikolai I. Pokhilko, and Jost B. Jonas
Subjects: Anterior chamber, Narrow anterior chamber angle, Angle-closure glaucoma, Lens vault, Intraocular pressure, Science (General), Q1-390, Social sciences (General), H1-99
Abstract: Purpose: To investigate the normative data of anterior chamber depth (ACD) and angle (ACA) and their associations in multiethnic cohorts spanning three generations in Russia. Methods: The study cohort included the participants of three population-based studies performed in urban and rural Bashkortostan/Russia: The Ural Eye and Medical Study (UEMS; age:40+ years), Ural Children Eye Study (UCES; age:6–18 years), and Ural Very Old Study (UVOS; age:85+ years). Using Scheimflug camera-based anterior chamber imaging, we measured ACD and ACA as part of a comprehensive ophthalmological and systemic examination. Exclusion criterion was previous cataract surgery. Results: The study included 4869 (98.7 %) children out of 4933 children of the UCES, 5426 (92.0 %) out of 5899 UEMS participants, and 268 (16.3 %) out of 1526 UVOS participants. In the UEMS, shallower ACD (mean:3.14 ± 0.37 mm) correlated (multivariable analysis; r[2] = 0.57) with older age (beta: 0.08;P
Published: 2023
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29. Global, regional, and national incidence of six major immune-mediated inflammatory diseases: findings from the global burden of disease study 2019Research in context

Author: Dongze Wu, Yingzhao Jin, Yuhan Xing, Melsew Dagne Abate, Mohammadreza Abbasian, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Foad Abd-Allah, Michael Abdelmasseh, Mohammad-Amin Abdollahifar, Deldar Morad Abdulah, Aidin Abedi, Vida Abedi, Hassan Abidi, Richard Gyan Aboagye, Hassan Abolhassani, Katrina Abuabara, Morteza Abyadeh, Isaac Yeboah Addo, Kayode Nelson Adeniji, Abiola Victor Adepoju, Miracle Ayomikun Adesina, Qorinah Estiningtyas Sakilah Adnani, Mohsen Afarideh, Shahin Aghamiri, Antonella Agodi, Anurag Agrawal, Constanza Elizabeth Aguilera Arriagada, Aqeel Ahmad, Danish Ahmad, Sajjad Ahmad, Sohail Ahmad, Ali Ahmadi, Ali Ahmed, Ayman Ahmed, Janardhana P. Aithala, Abdullateef Abiodun Ajadi, Marjan Ajami, Mostafa Akbarzadeh-Khiavi, Fares Alahdab, Mohammad T. AlBataineh, Sharifullah Alemi, Adel Ali Saeed Al-Gheethi, Liaqat Ali, Sheikh Mohammad Alif, Joseph Uy Almazan, Sami Almustanyir, Jaber S. Alqahtani, Ibrahim Alqasmi, Ihsan Ullah Khan Altaf, Nelson Alvis-Guzman, Nelson J. Alvis-Zakzuk, Yaser Mohammed Al-Worafi, Hany Aly, Reza Amani, Hubert Amu, Ganiyu Adeniyi Amusa, Catalina Liliana Andrei, Adnan Ansar, Hossein Ansariniya, Anayochukwu Edward Anyasodor, Jalal Arabloo, Reza Arefnezhad, Judie Arulappan, Mohammad Asghari-Jafarabadi, Tahira Ashraf, Jamila Abdulhamid Atata, Seyyed Shamsadin Athari, Daniel Atlaw, Maha Moh'd Wahbi Atout, Avinash Aujayeb, Asma Tahir Awan, Haleh Ayatollahi, Sina Azadnajafabad, Ahmed Y. Azzam, Alaa Badawi, Ashish D. Badiye, Sara Bagherieh, Atif Amin Baig, Berihun Bantie Bantie, Martina Barchitta, Mainak Bardhan, Suzanne Lyn Barker-Collo, Francesco Barone-Adesi, Kavita Batra, Nebiyou Simegnew Bayileyegn, Amir Hossein Behnoush, Uzma Iqbal Belgaumi, Maryam Bemanalizadeh, Isabela M. Bensenor, Kebede A. Beyene, Akshaya Srikanth Bhagavathula, Pankaj Bhardwaj, Sonu Bhaskar, Ajay Nagesh Bhat, Saeid Bitaraf, Veera R. Bitra, Archith Boloor, Kaustubh Bora, João Silva Botelho, Rachelle Buchbinder, Daniela Calina, Luis Alberto Cámera, Andre F. Carvalho, Jeffrey Shi Kai Chan, Vijay Kumar Chattu, Endeshaw Chekol Abebe, Fatemeh Chichagi, Sungchul Choi, Tzu-Chieh Chou, Dinh-Toi Chu, Kaleb Coberly, Vera Marisa Costa, Rosa A.S. Couto, Natália Cruz-Martins, Omid Dadras, Xiaochen Dai, Giovanni Damiani, Ana Maria Dascalu, Mohsen Dashti, Sisay Abebe Debela, Robert Paul Dellavalle, Andreas K. Demetriades, Alemayehu Anley Demlash, Xinlei Deng, Hardik Dineshbhai Desai, Rupak Desai, Syed Masudur Rahman Dewan, Sourav Dey, Samath Dhamminda Dharmaratne, Daniel Diaz, Mahmoud Dibas, Ricardo Jorge Dinis-Oliveira, Mengistie Diress, Thanh Chi Do, Duy Khanh Doan, Masoud Dodangeh, Milad Dodangeh, Deepa Dongarwar, John Dube, Arkadiusz Marian Dziedzic, Abdelaziz Ed-Dra, Hisham Atan Edinur, Negin Eissazade, Michael Ekholuenetale, Temitope Cyrus Ekundayo, Noha Mousaad Elemam, Muhammed Elhadi, Ahmed O. Elmehrath, Omar Abdelsadek Abdou Elmeligy, Mehdi Emamverdi, Theophilus I. Emeto, Hawi Leul Esayas, Habitu Birhan Eshetu, Farshid Etaee, Adeniyi Francis Fagbamigbe, Shahriar Faghani, Ildar Ravisovich Fakhradiyev, Ali Fatehizadeh, Mobina Fathi, Alireza Feizkhah, Ginenus Fekadu, Mohammad Fereidouni, Seyed-Mohammad Fereshtehnejad, João C. Fernandes, Pietro Ferrara, Getahun Fetensa, Irina Filip, Florian Fischer, Behzad Foroutan, Masoud Foroutan, Takeshi Fukumoto, Balasankar Ganesan, Belete Negese Belete Gemeda, Seyyed-Hadi Ghamari, MohammadReza Ghasemi, Maryam Gholamalizadeh, Tiffany K. Gill, Richard F. Gillum, Mohamad Goldust, Mahaveer Golechha, Pouya Goleij, Davide Golinelli, Houman Goudarzi, Shi-Yang Guan, Yang Guo, Bhawna Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Rasool Haddadi, Najah R. Hadi, Rabih Halwani, Shafiul Haque, Ikramul Hasan, Reza Hashempour, Amr Hassan, Treska S. Hassan, Sara Hassanzadeh, Mohammed Bheser Hassen, Johannes Haubold, Khezar Hayat, Golnaz Heidari, Mohammad Heidari, Reza Heidari-Soureshjani, Claudiu Herteliu, Kamran Hessami, Kamal Hezam, Yuta Hiraike, Ramesh Holla, Mohammad-Salar Hosseini, Hong-Han Huynh, Bing-Fang Hwang, Segun Emmanuel Ibitoye, Irena M. Ilic, Milena D. Ilic, Arad Iranmehr, Farideh Iravanpour, Nahlah Elkudssiah Ismail, Masao Iwagami, Chidozie C.D. Iwu, Louis Jacob, Morteza Jafarinia, Abdollah Jafarzadeh, Kasra Jahankhani, Haitham Jahrami, Mihajlo Jakovljevic, Elham Jamshidi, Chinmay T. Jani, Manthan Dilipkumar Janodia, Sathish Kumar Jayapal, Shubha Jayaram, Jayakumar Jeganathan, Jost B. Jonas, Abel Joseph, Nitin Joseph, Charity Ehimwenma Joshua, K. Vaishali, Billingsley Kaambwa, Ali Kabir, Zubair Kabir, Vidya Kadashetti, Feroze Kaliyadan, Fatemeh Kalroozi, Vineet Kumar Kamal, Amit Kandel, Himal Kandel, Srikanta Kanungo, Jafar Karami, Ibraheem M. Karaye, Hanie Karimi, Hengameh Kasraei, Sina Kazemian, Sewnet Adem Kebede, Leila Keikavoosi-Arani, Mohammad Keykhaei, Yousef Saleh Khader, Himanshu Khajuria, Faham Khamesipour, Ejaz Ahmad Khan, Imteyaz A. Khan, Maseer Khan, Md Jobair Khan, Moien A.B. Khan, Muhammad Arslan Khan, Haitham Khatatbeh, Moawiah Mohammad Khatatbeh, Sorour Khateri, Hamid Reza Khayat Kashani, Min Seo Kim, Adnan Kisa, Sezer Kisa, Hyun Yong Koh, Pavel Kolkhir, Oleksii Korzh, Ashwin Laxmikant Kotnis, Parvaiz A. Koul, Ai Koyanagi, Kewal Krishan, Mohammed Kuddus, Vishnutheertha Vishnutheertha Kulkarni, Narinder Kumar, Satyajit Kundu, Om P. Kurmi, Carlo La Vecchia, Chandrakant Lahariya, Tri Laksono, Judit Lám, Kamaluddin Latief, Paolo Lauriola, Basira Kankia Lawal, Thao Thi Thu Le, Trang Thi Bich Le, Munjae Lee, Seung Won Lee, Wei-Chen Lee, Yo Han Lee, Jacopo Lenzi, Miriam Levi, Wei Li, Virendra S. Ligade, Stephen S. Lim, Gang Liu, Xuefeng Liu, Erand Llanaj, Chun-Han Lo, Vanessa Sintra Machado, Azzam A. Maghazachi, Mansour Adam Mahmoud, Tuan A. Mai, Azeem Majeed, Pantea Majma Sanaye, Omar Mohamed Makram, Elaheh Malakan Rad, Kashish Malhotra, Ahmad Azam Malik, Iram Malik, Tauqeer Hussain Mallhi, Deborah Carvalho Malta, Mohammad Ali Mansournia, Lorenzo Giovanni Mantovani, Miquel Martorell, Sahar Masoudi, Seyedeh Zahra Masoumi, Yasith Mathangasinghe, Elezebeth Mathews, Alexander G. Mathioudakis, Andrea Maugeri, Mahsa Mayeli, John Robert Carabeo Medina, Gebrekiros Gebremichael Meles, José João Mendes, Ritesh G. Menezes, Tomislav Mestrovic, Irmina Maria Michalek, Ana Carolina Micheletti Gomide Nogueira de Sá, Ephrem Tesfaye Mihretie, Le Huu Nhat Minh, Reza Mirfakhraie, Erkin M. Mirrakhimov, Awoke Misganaw, Ashraf Mohamadkhani, Nouh Saad Mohamed, Faezeh Mohammadi, Soheil Mohammadi, Salahuddin Mohammed, Shafiu Mohammed, Syam Mohan, Anita Mohseni, Ali H. Mokdad, Sara Momtazmanesh, Lorenzo Monasta, Mohammad Ali Moni, Md Moniruzzaman, Yousef Moradi, Negar Morovatdar, Ebrahim Mostafavi, Parsa Mousavi, George Duke Mukoro, Admir Mulita, Getaneh Baye Mulu, Efrén Murillo-Zamora, Fungai Musaigwa, Ghulam Mustafa, Sathish Muthu, Firzan Nainu, Vinay Nangia, Sreenivas Narasimha Swamy, Zuhair S. Natto, Perumalsamy Navaraj, Biswa Prakash Nayak, Athare Nazri-Panjaki, Hadush Negash, Mohammad Hadi Nematollahi, Dang H. Nguyen, Hau Thi Hien Nguyen, Hien Quang Nguyen, Phat Tuan Nguyen, Van Thanh Nguyen, Robina Khan Niazi, Taxiarchis Konstantinos Nikolouzakis, Lawrence Achilles Nnyanzi, Mamoona Noreen, Chimezie Igwegbe Nzoputam, Ogochukwu Janet Nzoputam, Bogdan Oancea, In-Hwan Oh, Hassan Okati-Aliabad, Osaretin Christabel Okonji, Patrick Godwin Okwute, Andrew T. Olagunju, Matthew Idowu Olatubi, Isaac Iyinoluwa Olufadewa, Michal Ordak, Nikita Otstavnov, Mayowa O. Owolabi, P.A. Mahesh, Jagadish Rao Padubidri, Anton Pak, Reza Pakzad, Raffaele Palladino, Adrian Pana, Ioannis Pantazopoulos, Paraskevi Papadopoulou, Shahina Pardhan, Ashwaghosha Parthasarathi, Ava Pashaei, Jay Patel, Aslam Ramjan Pathan, Shankargouda Patil, Uttam Paudel, Shrikant Pawar, Paolo Pedersini, Umberto Pensato, David M. Pereira, Jeevan Pereira, Maria Odete Pereira, Renato B. Pereira, Mario F.P. Peres, Arokiasamy Perianayagam, Simone Perna, Ionela-Roxana Petcu, Parmida Sadat Pezeshki, Hoang Tran Pham, Anil K. Philip, Michael A. Piradov, Indrashis Podder, Vivek Podder, Dimitri Poddighe, Elton Junio Sady Prates, Ibrahim Qattea, Amir Radfar, Pourya Raee, Alireza Rafiei, Alberto Raggi, Fakher Rahim, Mehran Rahimi, Mahban Rahimifard, Vafa Rahimi-Movaghar, Md Obaidur Rahman, Mohammad Hifz Ur Rahman, Mosiur Rahman, Muhammad Aziz Rahman, Amir Masoud Rahmani, Mohamed Rahmani, Shayan Rahmani, Vahid Rahmanian, Premkumar Ramasubramani, Nemanja Rancic, Indu Ramachandra Rao, Sina Rashedi, Ahmed Mustafa Rashid, Nakul Ravikumar, Salman Rawaf, Elrashdy Moustafa Mohamed Redwan, Nazila Rezaei, Negar Rezaei, Nima Rezaei, Mohsen Rezaeian, Daniela Ribeiro, Mónica Rodrigues, Jefferson Antonio Buendia Rodriguez, Leonardo Roever, Esperanza Romero-Rodríguez, Aly M.A. Saad, Basema Saddik, Saeid Sadeghian, Umar Saeed, Azam Safary, Mahdi Safdarian, Sher Zaman Safi, Amene Saghazadeh, Dominic Sagoe, Fatemeh Saheb Sharif-Askari, Narjes Saheb Sharif-Askari, Amirhossein Sahebkar, Harihar Sahoo, Mohammad Ali Sahraian, Mirza Rizwan Sajid, Sateesh Sakhamuri, Joseph W. Sakshaug, Mohamed A. Saleh, Leili Salehi, Sana Salehi, Amir Salek Farrokhi, Sara Samadzadeh, Saad Samargandy, Noosha Samieefar, Abdallah M. Samy, Nima Sanadgol, Rama Krishna Sanjeev, Monika Sawhney, Ganesh Kumar Saya, Art Schuermans, Subramanian Senthilkumaran, Sadaf G. Sepanlou, Yashendra Sethi, Mahan Shafie, Humaira Shah, Izza Shahid, Samiah Shahid, Masood Ali Shaikh, Sadaf Sharfaei, Manoj Sharma, Maryam Shayan, Hatem Samir Shehata, Aziz Sheikh, Jeevan K. Shetty, Jae Il Shin, Reza Shirkoohi, Nebiyu Aniley Shitaye, K.M. Shivakumar, Velizar Shivarov, Parnian Shobeiri, Soraya Siabani, Migbar Mekonnen Sibhat, Emmanuel Edwar Siddig, Colin R. Simpson, Ehsan Sinaei, Harpreet Singh, Inderbir Singh, Jasvinder A. Singh, Paramdeep Singh, Surjit Singh, Md Shahjahan Siraj, Abdullah Al Mamun Sohag, Ranjan Solanki, Solikhah Solikhah, Yonatan Solomon, Mohammad Sadegh Soltani-Zangbar, Jing Sun, Mindy D. Szeto, Rafael Tabarés-Seisdedos, Seyyed Mohammad Tabatabaei, Mohammad Tabish, Ensiyeh Taheri, Azin Tahvildari, Iman M. Talaat, Jacques J.L. Lukenze Tamuzi, Ker-Kan Tan, Nathan Y. Tat, Razieh Tavakoli Oliaee, Arian Tavasol, Mohamad-Hani Temsah, Pugazhenthan Thangaraju, Samar Tharwat, Nigusie Selomon Tibebu, Jansje Henny Vera Ticoalu, Tala Tillawi, Tenaw Yimer Tiruye, Amir Tiyuri, Marcos Roberto Tovani-Palone, Manjari Tripathi, Guesh Mebrahtom Tsegay, Abdul Rohim Tualeka, Sree Sudha Ty, Chukwudi S. Ubah, Saif Ullah, Sana Ullah, Muhammad Umair, Srikanth Umakanthan, Era Upadhyay, Seyed Mohammad Vahabi, Asokan Govindaraj Vaithinathan, Sahel Valadan Tahbaz, Rohollah Valizadeh, Shoban Babu Varthya, Tommi Juhani Vasankari, Narayanaswamy Venketasubramanian, Georgios-Ioannis Verras, Jorge Hugo Villafañe, Vasily Vlassov, Danh Cao Vo, Yasir Waheed, Abdul Waris, Brhane Gebrehiwot Welegebrial, Ronny Westerman, Dakshitha Praneeth Wickramasinghe, Nuwan Darshana Wickramasinghe, Barbara Willekens, Beshada Zerfu Woldegeorgis, Melat Woldemariam, Hong Xiao, Dereje Y. Yada, Galal Yahya, Lin Yang, Fereshteh Yazdanpanah, Dong Keon Yon, Naohiro Yonemoto, Yuyi You, Mazyar Zahir, Syed Saoud Zaidi, Moein Zangiabadian, Iman Zare, Mohammad A. Zeineddine, Dawit T. Zemedikun, Naod Gebrekrstos Zeru, Chen Zhang, Hanqing Zhao, Chenwen Zhong, Magdalena Zielińska, Mohammad Zoladl, Alimuddin Zumla, Cui Guo, and Lai-shan Tam
Subjects: Immune-mediated inflammatory disease, Incidence, Global burden of disease study, Trend, Medicine (General), R5-920
Abstract: Summary: Background: The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. Methods: We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. Findings: In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of −0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = −0.41), inflammatory bowel disease (AAPC = −0.72), multiple sclerosis (AAPC = −0.26), psoriasis (AAPC = −0.77), and atopic dermatitis (AAPC = −0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. Interpretation: The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively. Funding: The Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation. The project funded by Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (2022QN38).
Published: 2023
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30. Chronic limb threatening disease, diabetic nephropathy and diabetic retinopathy in patients with type 1 diabetes

Author: Jost B. Jonas
Subjects: Public aspects of medicine, RA1-1270
Published: 2023
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31. Myopic macular Bruch’s membrane defects

Author: Songhomitra Panda-Jonas, Gerd U. Auffarth, Jost B. Jonas, and Rahul A. Jonas
Subjects: Bruch’s membrane defects, Bruch’s membrane, Myopia, Myopic maculopathy, Myopic macular degeneration, Axial myopia, Science (General), Q1-390, Social sciences (General), H1-99
Abstract: Purpose: To examine histologic characteristics of macular Bruchś membrane defects (BMD) in axially elongated eyes. Design: Histomorphometric study. Methods: Using light microscopy, we examined enucleated human globes for BMDs. Results: In 247 eyes, BMDs were detected in 15 (6.1%) eyes (axial length:27.0–36.0 mm), in 10 of them in the macular region. Prevalence and size of BMDs (mean:1.93 ± 1.62 mm; range:0.22mm–6.24 mm) correlated with longer axial length (OR:1.52; 95%CI:1.19,1.94; P = 0.001) and higher prevalence of scleral staphylomas (OR:16.3; 95%CI:2.67,99.3; P 0.05) between the BDM border and adjacent areas. In the BMD, choriocapillaris and RPE were absent. The sclera was thinner in the BDM area than in adjacent areas (0.28 ± 0.19 mm versus 0.36 ± 0.13 mm; P = 0.006). Conclusions: BMDs as hallmarks of myopic macular degeneration are characterized by longer gaps in the RPE and smaller gaps in the outer nuclear layer and inner nuclear layer, by localized scleral thinning, and by a spatial association with scleral staphylomas. Thickness of the choriocapillaris and density of the RPE cell layer, both absent within the BDMs, do not vary between the BMD border and adjacent regions. The results suggest an association between BDMs and absolute scotomas, stretching of the adjacent retinal nerve fiver layer, and an axial elongation-associated stretching effect on BM as etiology of the BDMs.
Published: 2023
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32. Prevalence of metabolic syndrome in a Russian population: The Ural Eye and Medical Study and the Ural Very Old Study

Author: Mukharram M. Bikbov, Gyulli M. Kazakbaeva, Timur R. Gilmanshin, Rinat M. Zainullin, Ellina M. Iakupova, Albina A. Fakhretdinova, Azaliia M. Tuliakova, Iuliia A. Rusakova, Songhomitra Panda-Jonas, Ildar F. Nuriev, Artur F. Zaynetdinov, Ainur A. Zinnatullin, Inga I. Arslangareeva, Ainur V. Gizzatov, Natalia I. Bolshakova, Kamilia R. Safiullina, and Jost B. Jonas
Subjects: Metabolic syndrome, Hyperlipidemia, Arterial hypertension, Hyperglycemia, Population-based study, Russia, Physiology, QP1-981, Biochemistry, QD415-436
Abstract: Purpose: To examine prevalence and associated factors of the metabolic syndrome (MS) in populations in Russia. Methods: Two population-based studies (Ural Eye and Medical Study (UEMS), Ural Very Old Study (UVOS)) were conducted in rural and urban regions in Bashkortostan/Russia and included participants aged 40+ years and 85+ years, respectively. Results: Out of 5895 UEMS participants, 1572 individuals had MS (prevalence:26.7%; 95% confidence interval (CI):25.5,27.8). The criteria of waist circumference, blood pressure, hyperglycemia, serum high-density lipoprotein concentration and serum triglyceride concentration were fulfilled by 4269 (72.4%; 95%CI:71.3,73.6), 3168 (53.7%; 95%CI:52.5,55.1), 1375 (23.3%; 95%CI:22.4,24.6), 712 (13.3%; 95%CI:12.4,14.2), and 1527 (28.6%; 95%CI:27.4,29.8) individuals, respectively. Higher MS prevalence was associated with older age (odds ratio (OR):1.03; 95%CI:1.02,1.04;P
Published: 2022
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33. Estimated pulse wave velocity and cardiovascular events in Chinese

Author: Chunpeng Ji, Jingli Gao, Zhe Huang, Shuohua Chen, Guodong Wang, Shouling Wu, and Jost B. Jonas
Subjects: Pulse wave velocity, Brachial-ankle pulse wave velocity, Carotid-ankle pulse wave velocity, Blood pressure, Arteriosclerosis, Hypertension, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: The estimated pulse-wave velocity (ePWV) as measure for arterial wall stiffness is associated with an increased risk of cardiovascular disease (CVDs) and all-cause death in Western populations. We investigated the association between ePWV and the incidence of CVDs (myocardial infarction, cerebral infarction, cerebral hemorrhage) and all-cause death in Chinese. The community-based longitudinal Kailuan Study included 98,348 participants undergoing biennial clinical examinations. During a mean follow-up of 10.32 ± 2.14 years, 6967 CVD events (myocardial infarction, n = 1610; cerebral infarction, n = 4634; cerebral hemorrhage, n = 1071) and 9780 all-cause deaths occurred. Stratified by age, sex and presence of cardiovascular risk factors, the incidence of CVDs and all-cause death were higher (P
Published: 2020
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34. Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000–17

Author: Aniruddha Deshpande, Molly K Miller-Petrie, Paulina A Lindstedt, Mathew M Baumann, Kimberly B Johnson, Brigette F Blacker, Hedayat Abbastabar, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R.M. Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Abdu A Adamu, Oladimeji M Adebayo, Isaac Akinkunmi Adedeji, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O Adetokunboh, Tara Ballav Adhikari, Mohsen Afarideh, Marcela Agudelo-Botero, Mehdi Ahmadi, Keivan Ahmadi, Muktar Beshir Ahmed, Anwar E Ahmed, Temesgen Yihunie Akalu, Ali S Akanda, Fares Alahdab, Ziyad Al-Aly, Samiah Alam, Noore Alam, Genet Melak Alamene, Turki M Alanzi, James Albright, Ammar Albujeer, Jacqueline Elizabeth Alcalde-Rabanal, Animut Alebel, Zewdie Aderaw Alemu, Muhammad Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J. Alvis-Zakzuk, Saeed Amini, Arianna Maever L. Amit, Gianna Gayle Herrera Amul, Catalina Liliana Andrei, Mina Anjomshoa, Ansariadi Ansariadi, Carl Abelardo T. Antonio, Benny Antony, Ernoiz Antriyandarti, Jalal Arabloo, Hany Mohamed Amin Aref, Olatunde Aremu, Bahram Armoon, Amit Arora, Krishna K Aryal, Afsaneh Arzani, Mehran Asadi-Aliabadi, Daniel Asmelash, Hagos Tasew Atalay, Seyyede Masoume Athari, Seyyed Shamsadin Athari, Sachin R Atre, Marcel Ausloos, Shally Awasthi, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Martin Amogre Ayanore, Yared Asmare Aynalem, Samad Azari, Andrew S Azman, Ebrahim Babaee, Alaa Badawi, Mojtaba Bagherzadeh, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Maciej Banach, Joseph Adel Mattar Banoub, Aleksandra Barac, Miguel A Barboza, Till Winfried Bärnighausen, Sanjay Basu, Vo Dinh Bay, Mohsen Bayati, Neeraj Bedi, Mahya Beheshti, Meysam Behzadifar, Masoud Behzadifar, Diana Fernanda Bejarano Ramirez, Michelle L Bell, Derrick A. Bennett, Habib Benzian, Dessalegn Ajema Berbada, Robert S Bernstein, Anusha Ganapati Bhat, Krittika Bhattacharyya, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Ali Bijani, Boris Bikbov, Muhammad Shahdaat Bin Sayeed, Raaj Kishore Biswas, Somayeh Bohlouli, Soufiane Boufous, Oliver J Brady, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Gabrielle B Britton, Alexandria Brown, Sharath Burugina Nagaraja, Zahid A Butt, Luis Alberto Cámera, Ismael R Campos-Nonato, Julio Cesar Campuzano Rincon, Jorge Cano, Josip Car, Rosario Cárdenas, Felix Carvalho, Carlos A Castañeda-Orjuela, Franz Castro, Ester Cerin, Binaya Chalise, Vijay Kumar Chattu, Ken Lee Chin, Devasahayam J Christopher, Dinh-Toi Chu, Natalie Maria Cormier, Vera Marisa Costa, Elizabeth A Cromwell, Abel Fekadu Fekadu Dadi, Tukur Dahiru, Saad M A Dahlawi, Rakhi Dandona, Lalit Dandona, Anh Kim Dang, Farah Daoud, Aso Mohammad Darwesh, Amira Hamed Darwish, Ahmad Daryani, Jai K Das, Rajat Das Gupta, Aditya Prasad Dash, Claudio Alberto Dávila-Cervantes, Nicole Davis Weaver, Fernando Pio De la Hoz, Jan-Walter De Neve, Dereje Bayissa Demissie, Gebre Teklemariam Demoz, Edgar Denova-Gutiérrez, Kebede Deribe, Assefa Desalew, Samath Dhamminda Dharmaratne, Preeti Dhillon, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Isaac Oluwafemi Dipeolu, Hoa Thi Do, Christiane Dolecek, Kerrie E Doyle, Eleonora Dubljanin, Andre Rodrigues Duraes, Hisham Atan Edinur, Andem Effiong, Aziz Eftekhari, Nevine El Nahas, Maysaa El Sayed Zaki, Maha El Tantawi, Hala Rashad Elhabashy, Shaimaa I. El-Jaafary, Ziad El-Khatib, Hajer Elkout, Aisha Elsharkawy, Shymaa Enany, Daniel Adane Endalew, Babak Eshrati, Sharareh Eskandarieh, Arash Etemadi, Oluchi Ezekannagha, Emerito Jose A. Faraon, Mohammad Fareed, Andre Faro, Farshad Farzadfar, Alebachew Fasil Fasil, Mehdi Fazlzadeh, Valery L. Feigin, Wubalem Fekadu, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Carsten Flohr, Nataliya A. Foigt, Morenike Oluwatoyin Folayan, Masoud Foroutan, Richard Charles Franklin, Joseph Jon Frostad, Takeshi Fukumoto, Mohamed M Gad, Gregory M Garcia, Augustine Mwangi Gatotoh, Reta Tsegaye Gayesa, Ketema Bizuwork Gebremedhin, Yilma Chisha Dea Geramo, Hailay Abrha Gesesew, Kebede Embaye Gezae, Ahmad Ghashghaee, Farzaneh Ghazi Sherbaf, Tiffany K Gill, Paramjit Singh Gill, Themba G Ginindza, Alem Girmay, Zemichael Gizaw, Amador Goodridge, Sameer Vali Gopalani, Bárbara Niegia Garcia Goulart, Alessandra C Goulart, Ayman Grada, Manfred S Green, Mohammed Ibrahim Mohialdeen Gubari, Harish Chander Gugnani, Davide Guido, Rafael Alves Guimarães, Yuming Guo, Rajeev Gupta, Rahul Gupta, Giang Hai Ha, Juanita A. Haagsma, Nima Hafezi-Nejad, Dessalegn H Haile, Michael Tamene Haile, Brian J. Hall, Samer Hamidi, Demelash Woldeyohannes Handiso, Hamidreza Haririan, Ninuk Hariyani, Ahmed I. Hasaballah, Md. Mehedi Hasan, Amir Hasanzadeh, Hamid Yimam Hassen, Desta Haftu Hayelom, Mohamed I Hegazy, Behzad Heibati, Behnam Heidari, Delia Hendrie, Andualem Henok, Claudiu Herteliu, Fatemeh Heydarpour, Hagos Degefa de Hidru, Thomas R Hird, Chi Linh Hoang, Gillian I Hollerich, Praveen Hoogar, Naznin Hossain, Mehdi Hosseinzadeh, Mowafa Househ, Guoqing Hu, Ayesha Humayun, Syed Ather Hussain, Mamusha Aman A Hussen, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Milena D. Ilic, Mohammad Hasan Imani-Nasab, Usman Iqbal, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Rebecca Q Ivers, Chinwe Juliana Iwu, Nader Jahanmehr, Mihajlo Jakovljevic, Amir Jalali, Achala Upendra Jayatilleke, Ensiyeh Jenabi, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Jost B. Jonas, Jacek Jerzy Jozwiak, Ali Kabir, Zubair Kabir, Tanuj Kanchan, André Karch, Surendra Karki, Amir Kasaeian, Gebremicheal Gebreslassie Kasahun, Habtamu Kebebe Kasaye, Gebrehiwot G Kassa, Getachew Mullu Kassa, Gbenga A. Kayode, Mihiretu M Kebede, Peter Njenga Keiyoro, Daniel Bekele Ketema, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Nauman Khalid, Rovshan Khalilov, Ejaz Ahmad Khan, Junaid Khan, Md Nuruzzaman Khan, Khaled Khatab, Mona M Khater, Amir M Khater, Maryam Khayamzadeh, Mohammad Khazaei, Mohammad Hossein Khosravi, Jagdish Khubchandani, Ali Kiadaliri, Yun Jin Kim, Ruth W Kimokoti, Sezer Kisa, Adnan Kisa, Sonali Kochhar, Tufa Kolola, Hamidreza Komaki, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Kewal Krishan, Barthelemy Kuate Defo, Nuworza Kugbey, Pushpendra Kumar, G Anil Kumar, Manasi Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Aparna Lal, Dharmesh Kumar Lal, Hilton Lam, Faris Hasan Lami, Van Charles Lansingh, Savita Lasrado, Georgy Lebedev, Paul H Lee, Kate E LeGrand, Mostafa Leili, Tsegaye Lolaso Lenjebo, Cheru Tesema Leshargie, Aubrey J Levine, Sonia Lewycka, Shanshan Li, Shai Linn, Shiwei Liu, Jaifred Christian F Lopez, Platon D Lopukhov, Muhammed Magdy Abd El Razek, D.R. Mahadeshwara Prasad, Phetole Walter Mahasha, Narayan B. Mahotra, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Abdullah A Mamun, Navid Manafi, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Gabriel Martinez, Santi Martini, Francisco Rogerlândio Martins-Melo, Manu Raj Mathur, Benjamin K Mayala, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Man Mohan Mehndiratta, Entezar Mehrabi Nasab, Kala M Mehta, Teferi Mekonnen, Tefera Chane Mekonnen, Gebrekiros Gebremichael Meles, Hagazi Gebre Meles, Peter T N Memiah, Ziad A Memish, Walter Mendoza, Ritesh G Menezes, Seid Tiku Mereta, Tuomo J Meretoja, Tomislav Mestrovic, Workua Mekonnen Metekiya, Bartosz Miazgowski, Ted R Miller, GK Mini, Erkin M Mirrakhimov, Babak Moazen, Bahram Mohajer, Yousef Mohammad, Dara K. Mohammad, Naser Mohammad Gholi Mezerji, Roghayeh Mohammadibakhsh, Shafiu Mohammed, Jemal Abdu Mohammed, Hassen Mohammed, Farnam Mohebi, Ali H Mokdad, Yoshan Moodley, Masoud Moradi, Ghobad Moradi, Mohammad Moradi-Joo, Paula Moraga, Linda Morales, Abbas Mosapour, Jonathan F. Mosser, Simin Mouodi, Seyyed Meysam Mousavi, Miliva Mozaffor, Sandra B Munro, Moses K. Muriithi, Christopher J L Murray, Kamarul Imran Musa, Ghulam Mustafa, Saravanan Muthupandian, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Mohsen Naghavi, Gurudatta Naik, Vinay Nangia, Bruno Ramos Nascimento, Javad Nazari, Duduzile Edith Ndwandwe, Ionut Negoi, Henok Biresaw Netsere, Josephine W. Ngunjiri, Cuong Tat Nguyen, Huong Lan Thi Nguyen, QuynhAnh P Nguyen, Solomon Gedlu Nigatu, Dina Nur Anggraini Ningrum, Chukwudi A Nnaji, Marzieh Nojomi, Ole F Norheim, Jean Jacques Noubiap, Bogdan Oancea, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Jacob Olusegun Olusanya, Bolajoko Olubukunola Olusanya, Obinna E Onwujekwe, Doris V. Ortega-Altamirano, Osayomwanbo Osarenotor, Frank B Osei, Mayowa O Owolabi, Mahesh P A, Jagadish Rao. Padubidri, Smita Pakhale, Adrian Pana, Eun-Kee Park, Sangram Kishor Patel, Ashish Pathak, Ajay Patle, Kebreab Paulos, Veincent Christian Filipino Pepito, Norberto Perico, Aslam Pervaiz, Julia Moreira Pescarini, Konrad Pesudovs, Hai Quang Pham, David M Pigott, Thomas Pilgrim, Meghdad Pirsaheb, Mario Poljak, Ian Pollock, Maarten J Postma, Farshad Pourmalek, Akram Pourshams, Sergio I Prada, Liliana Preotescu, Hedley Quintana, Navid Rabiee, Mohammad Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Siavash Rahimi, Vafa Rahimi-Movaghar, Muhammad Aziz Rahman, Mohammad Hifz Ur Rahman, Fatemeh Rajati, Chhabi Lal Ranabhat, Puja C Rao, Davide Rasella, Goura Kishor Rath, Salman Rawaf, Lal Rawal, Wasiq Faraz Rawasia, Giuseppe Remuzzi, Vishnu Renjith, Andre M.N. Renzaho, Serge Resnikoff, Seyed Mohammad Riahi, Ana Isabel Ribeiro, Jennifer Rickard, Leonardo Roever, Luca Ronfani, Enrico Rubagotti, Salvatore Rubino, Anas M Saad, Siamak Sabour, Ehsan Sadeghi, Sahar Saeedi Moghaddam, Yahya Safari, Rajesh Sagar, Mohammad Ali Sahraian, S. Mohammad Sajadi, Mohammad Reza Salahshoor, Nasir Salam, Ahsan Saleem, Hosni Salem, Marwa Rashad Salem, Yahya Salimi, Hamideh Salimzadeh, Abdallah M Samy, Juan Sanabria, Itamar S Santos, Milena M. Santric-Milicevic, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, Nizal Sarrafzadegan, Benn Sartorius, Brijesh Sathian, Thirunavukkarasu Sathish, Maheswar Satpathy, Monika Sawhney, Mehdi Sayyah, Alyssa N Sbarra, Lauren E Schaeffer, David C Schwebel, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Azadeh Shafieesabet, Amira A Shaheen, Izza Shahid, Masood Ali Shaikh, Ali S Shalash, Mehran Shams-Beyranvand, MohammadBagher Shamsi, Morteza Shamsizadeh, Mohammed Shannawaz, Kiomars Sharafi, Rajesh Sharma, Aziz Sheikh, B Suresh Kumar Shetty, Wondimeneh Shibabaw Shiferaw, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Reza Shirkoohi, K M Shivakumar, Si Si, Soraya Siabani, Tariq Jamal Siddiqi, Diego Augusto Santos Silva, Virendra Singh, Narinder Pal Singh, Balbir Bagicha Singh Singh, Jasvinder A. Singh, Ambrish Singh, Dhirendra Narain Sinha, Malede Mequanent Sisay, Eirini Skiadaresi, David L Smith, Adauto Martins Soares Filho, Mohammad Reza Sobhiyeh, Anton Sokhan, Joan B Soriano, Muluken Bekele Sorrie, Ireneous N Soyiri, Emma Elizabeth Spurlock, Chandrashekhar T Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Hafiz Ansar Rasul Suleria, Bryan L. Sykes, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Degena Bahrey Tadesse, Ingan Ukur Tarigan, Bineyam Taye, Yonatal Mesfin Tefera, Arash Tehrani-Banihashemi, Shishay Wahdey Tekelemedhin, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Berhe Etsay Tesfay, Fisaha Haile Tesfay, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Akhil Soman ThekkePurakkal, Nihal Thomas, Robert L Thompson, Alan J Thomson, Roman Topor-Madry, Marcos Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Bhaskaran Unnikrishnan, Muhammad Shariq Usman, Olalekan A Uthman, Benjamin S. Chudi Uzochukwu, Pascual R Valdez, Santosh Varughese, Yousef Veisani, Francesco S Violante, Sebastian Vollmer, Feleke Gebremeskel W/hawariat, Yasir Waheed, Mitchell Taylor Wallin, Yuan-Pang Wang, Yafeng Wang, Kinley Wangdi, Daniel J Weiss, Girmay Teklay Weldesamuel, Adhena Ayaliew Werkneh, Ronny Westerman, Taweewat Wiangkham, Kirsten E Wiens, Tissa Wijeratne, Charles Shey Wiysonge, Haileab Fekadu Wolde, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Getasew Taddesse Worku, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Mehdi Yaseri, Hiroshi Yatsuya, Alex Yeshaneh, Mekdes Tigistu Yilma, Paul Yip, Engida Yisma, Naohiro Yonemoto, Mustafa Z Younis, Hebat-Allah Salah A Yousof, Chuanhua Yu, Hasan Yusefzadeh, Siddhesh Zadey, Telma Zahirian Moghadam, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Heather J Zar, Taddese Alemu Zerfu, Yunquan Zhang, Arash Ziapour, Sanjay Zodpey, Yves Miel H Zuniga, Simon I Hay, and Robert C Reiner, Jr
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. Methods: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings: Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4–40·7) to 50·3% (50·0–50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1–46·5) in 2017, compared with 28·7% (28·5–29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2–89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664–711) of the 1830 (1797–1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6–80·7) of countries from 2000 to 2017, and in 53·9% (50·6–59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation: Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation. Funding: Bill & Melinda Gates Foundation.
Published: 2020
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35. The global distribution of lymphatic filariasis, 2000–18: a geospatial analysis

Author: Aniruddha Deshpande, Molly K Miller-Petrie, Paulina A Lindstedt, Mathew M Baumann, Kimberly B Johnson, Brigette F Blacker, Hedayat Abbastabar, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R.M. Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Abdu A Adamu, Oladimeji M Adebayo, Isaac Akinkunmi Adedeji, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O Adetokunboh, Tara Ballav Adhikari, Mohsen Afarideh, Marcela Agudelo-Botero, Mehdi Ahmadi, Keivan Ahmadi, Muktar Beshir Ahmed, Anwar E Ahmed, Temesgen Yihunie Akalu, Ali S Akanda, Fares Alahdab, Ziyad Al-Aly, Samiah Alam, Noore Alam, Genet Melak Alamene, Turki M Alanzi, James Albright, Ammar Albujeer, Jacqueline Elizabeth Alcalde-Rabanal, Animut Alebel, Zewdie Aderaw Alemu, Muhammad Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J. Alvis-Zakzuk, Saeed Amini, Arianna Maever L. Amit, Gianna Gayle Herrera Amul, Catalina Liliana Andrei, Mina Anjomshoa, Ansariadi Ansariadi, Carl Abelardo T. Antonio, Benny Antony, Ernoiz Antriyandarti, Jalal Arabloo, Hany Mohamed Amin Aref, Olatunde Aremu, Bahram Armoon, Amit Arora, Krishna K Aryal, Afsaneh Arzani, Mehran Asadi-Aliabadi, Daniel Asmelash, Hagos Tasew Atalay, Seyyede Masoume Athari, Seyyed Shamsadin Athari, Sachin R Atre, Marcel Ausloos, Shally Awasthi, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Martin Amogre Ayanore, Yared Asmare Aynalem, Samad Azari, Andrew S Azman, Ebrahim Babaee, Alaa Badawi, Mojtaba Bagherzadeh, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Maciej Banach, Joseph Adel Mattar Banoub, Aleksandra Barac, Miguel A Barboza, Till Winfried Bärnighausen, Sanjay Basu, Vo Dinh Bay, Mohsen Bayati, Neeraj Bedi, Mahya Beheshti, Meysam Behzadifar, Masoud Behzadifar, Diana Fernanda Bejarano Ramirez, Michelle L Bell, Derrick A. Bennett, Habib Benzian, Dessalegn Ajema Berbada, Robert S Bernstein, Anusha Ganapati Bhat, Krittika Bhattacharyya, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Ali Bijani, Boris Bikbov, Muhammad Shahdaat Bin Sayeed, Raaj Kishore Biswas, Somayeh Bohlouli, Soufiane Boufous, Oliver J Brady, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Gabrielle B Britton, Alexandria Brown, Sharath Burugina Nagaraja, Zahid A Butt, Luis Alberto Cámera, Ismael R Campos-Nonato, Julio Cesar Campuzano Rincon, Jorge Cano, Josip Car, Rosario Cárdenas, Felix Carvalho, Carlos A Castañeda-Orjuela, Franz Castro, Ester Cerin, Binaya Chalise, Vijay Kumar Chattu, Ken Lee Chin, Devasahayam J Christopher, Dinh-Toi Chu, Natalie Maria Cormier, Vera Marisa Costa, Elizabeth A Cromwell, Abel Fekadu Fekadu Dadi, Tukur Dahiru, Saad M A Dahlawi, Rakhi Dandona, Lalit Dandona, Anh Kim Dang, Farah Daoud, Aso Mohammad Darwesh, Amira Hamed Darwish, Ahmad Daryani, Jai K Das, Rajat Das Gupta, Aditya Prasad Dash, Claudio Alberto Dávila-Cervantes, Nicole Davis Weaver, Fernando Pio De la Hoz, Jan-Walter De Neve, Dereje Bayissa Demissie, Gebre Teklemariam Demoz, Edgar Denova-Gutiérrez, Kebede Deribe, Assefa Desalew, Samath Dhamminda Dharmaratne, Preeti Dhillon, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Isaac Oluwafemi Dipeolu, Hoa Thi Do, Christiane Dolecek, Kerrie E Doyle, Eleonora Dubljanin, Andre Rodrigues Duraes, Hisham Atan Edinur, Andem Effiong, Aziz Eftekhari, Nevine El Nahas, Maysaa El Sayed Zaki, Maha El Tantawi, Hala Rashad Elhabashy, Shaimaa I. El-Jaafary, Ziad El-Khatib, Hajer Elkout, Aisha Elsharkawy, Shymaa Enany, Daniel Adane Endalew, Babak Eshrati, Sharareh Eskandarieh, Arash Etemadi, Oluchi Ezekannagha, Emerito Jose A. Faraon, Mohammad Fareed, Andre Faro, Farshad Farzadfar, Alebachew Fasil Fasil, Mehdi Fazlzadeh, Valery L. Feigin, Wubalem Fekadu, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Carsten Flohr, Nataliya A. Foigt, Morenike Oluwatoyin Folayan, Masoud Foroutan, Richard Charles Franklin, Joseph Jon Frostad, Takeshi Fukumoto, Mohamed M Gad, Gregory M Garcia, Augustine Mwangi Gatotoh, Reta Tsegaye Gayesa, Ketema Bizuwork Gebremedhin, Yilma Chisha Dea Geramo, Hailay Abrha Gesesew, Kebede Embaye Gezae, Ahmad Ghashghaee, Farzaneh Ghazi Sherbaf, Tiffany K Gill, Paramjit Singh Gill, Themba G Ginindza, Alem Girmay, Zemichael Gizaw, Amador Goodridge, Sameer Vali Gopalani, Bárbara Niegia Garcia Goulart, Alessandra C Goulart, Ayman Grada, Manfred S Green, Mohammed Ibrahim Mohialdeen Gubari, Harish Chander Gugnani, Davide Guido, Rafael Alves Guimarães, Yuming Guo, Rajeev Gupta, Rahul Gupta, Giang Hai Ha, Juanita A. Haagsma, Nima Hafezi-Nejad, Dessalegn H Haile, Michael Tamene Haile, Brian J. Hall, Samer Hamidi, Demelash Woldeyohannes Handiso, Hamidreza Haririan, Ninuk Hariyani, Ahmed I. Hasaballah, Md. Mehedi Hasan, Amir Hasanzadeh, Hamid Yimam Hassen, Desta Haftu Hayelom, Mohamed I Hegazy, Behzad Heibati, Behnam Heidari, Delia Hendrie, Andualem Henok, Claudiu Herteliu, Fatemeh Heydarpour, Hagos Degefa de Hidru, Thomas R Hird, Chi Linh Hoang, Gillian I Hollerich, Praveen Hoogar, Naznin Hossain, Mehdi Hosseinzadeh, Mowafa Househ, Guoqing Hu, Ayesha Humayun, Syed Ather Hussain, Mamusha Aman A Hussen, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Milena D. Ilic, Mohammad Hasan Imani-Nasab, Usman Iqbal, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Rebecca Q Ivers, Chinwe Juliana Iwu, Nader Jahanmehr, Mihajlo Jakovljevic, Amir Jalali, Achala Upendra Jayatilleke, Ensiyeh Jenabi, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Jost B. Jonas, Jacek Jerzy Jozwiak, Ali Kabir, Zubair Kabir, Tanuj Kanchan, André Karch, Surendra Karki, Amir Kasaeian, Gebremicheal Gebreslassie Kasahun, Habtamu Kebebe Kasaye, Gebrehiwot G Kassa, Getachew Mullu Kassa, Gbenga A. Kayode, Mihiretu M Kebede, Peter Njenga Keiyoro, Daniel Bekele Ketema, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Nauman Khalid, Rovshan Khalilov, Ejaz Ahmad Khan, Junaid Khan, Md Nuruzzaman Khan, Khaled Khatab, Mona M Khater, Amir M Khater, Maryam Khayamzadeh, Mohammad Khazaei, Mohammad Hossein Khosravi, Jagdish Khubchandani, Ali Kiadaliri, Yun Jin Kim, Ruth W Kimokoti, Sezer Kisa, Adnan Kisa, Sonali Kochhar, Tufa Kolola, Hamidreza Komaki, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Kewal Krishan, Barthelemy Kuate Defo, Nuworza Kugbey, Pushpendra Kumar, G Anil Kumar, Manasi Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Aparna Lal, Dharmesh Kumar Lal, Hilton Lam, Faris Hasan Lami, Van Charles Lansingh, Savita Lasrado, Georgy Lebedev, Paul H Lee, Kate E LeGrand, Mostafa Leili, Tsegaye Lolaso Lenjebo, Cheru Tesema Leshargie, Aubrey J Levine, Sonia Lewycka, Shanshan Li, Shai Linn, Shiwei Liu, Jaifred Christian F Lopez, Platon D Lopukhov, Muhammed Magdy Abd El Razek, D.R. Mahadeshwara Prasad, Phetole Walter Mahasha, Narayan B. Mahotra, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Abdullah A Mamun, Navid Manafi, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Gabriel Martinez, Santi Martini, Francisco Rogerlândio Martins-Melo, Manu Raj Mathur, Benjamin K Mayala, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Man Mohan Mehndiratta, Entezar Mehrabi Nasab, Kala M Mehta, Teferi Mekonnen, Tefera Chane Mekonnen, Gebrekiros Gebremichael Meles, Hagazi Gebre Meles, Peter T N Memiah, Ziad A Memish, Walter Mendoza, Ritesh G Menezes, Seid Tiku Mereta, Tuomo J Meretoja, Tomislav Mestrovic, Workua Mekonnen Metekiya, Bartosz Miazgowski, Ted R Miller, GK Mini, Erkin M Mirrakhimov, Babak Moazen, Bahram Mohajer, Yousef Mohammad, Dara K. Mohammad, Naser Mohammad Gholi Mezerji, Roghayeh Mohammadibakhsh, Shafiu Mohammed, Jemal Abdu Mohammed, Hassen Mohammed, Farnam Mohebi, Ali H Mokdad, Yoshan Moodley, Masoud Moradi, Ghobad Moradi, Mohammad Moradi-Joo, Paula Moraga, Linda Morales, Abbas Mosapour, Jonathan F. Mosser, Simin Mouodi, Seyyed Meysam Mousavi, Miliva Mozaffor, Sandra B Munro, Moses K. Muriithi, Christopher J L Murray, Kamarul Imran Musa, Ghulam Mustafa, Saravanan Muthupandian, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Mohsen Naghavi, Gurudatta Naik, Vinay Nangia, Bruno Ramos Nascimento, Javad Nazari, Duduzile Edith Ndwandwe, Ionut Negoi, Henok Biresaw Netsere, Josephine W. Ngunjiri, Cuong Tat Nguyen, Huong Lan Thi Nguyen, QuynhAnh P Nguyen, Solomon Gedlu Nigatu, Dina Nur Anggraini Ningrum, Chukwudi A Nnaji, Marzieh Nojomi, Ole F Norheim, Jean Jacques Noubiap, Bogdan Oancea, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Jacob Olusegun Olusanya, Bolajoko Olubukunola Olusanya, Obinna E Onwujekwe, Doris V. Ortega-Altamirano, Osayomwanbo Osarenotor, Frank B Osei, Mayowa O Owolabi, Mahesh P A, Jagadish Rao. Padubidri, Smita Pakhale, Adrian Pana, Eun-Kee Park, Sangram Kishor Patel, Ashish Pathak, Ajay Patle, Kebreab Paulos, Veincent Christian Filipino Pepito, Norberto Perico, Aslam Pervaiz, Julia Moreira Pescarini, Konrad Pesudovs, Hai Quang Pham, David M Pigott, Thomas Pilgrim, Meghdad Pirsaheb, Mario Poljak, Ian Pollock, Maarten J Postma, Farshad Pourmalek, Akram Pourshams, Sergio I Prada, Liliana Preotescu, Hedley Quintana, Navid Rabiee, Mohammad Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Siavash Rahimi, Vafa Rahimi-Movaghar, Muhammad Aziz Rahman, Mohammad Hifz Ur Rahman, Fatemeh Rajati, Chhabi Lal Ranabhat, Puja C Rao, Davide Rasella, Goura Kishor Rath, Salman Rawaf, Lal Rawal, Wasiq Faraz Rawasia, Giuseppe Remuzzi, Vishnu Renjith, Andre M.N. Renzaho, Serge Resnikoff, Seyed Mohammad Riahi, Ana Isabel Ribeiro, Jennifer Rickard, Leonardo Roever, Luca Ronfani, Enrico Rubagotti, Salvatore Rubino, Anas M Saad, Siamak Sabour, Ehsan Sadeghi, Sahar Saeedi Moghaddam, Yahya Safari, Rajesh Sagar, Mohammad Ali Sahraian, S. Mohammad Sajadi, Mohammad Reza Salahshoor, Nasir Salam, Ahsan Saleem, Hosni Salem, Marwa Rashad Salem, Yahya Salimi, Hamideh Salimzadeh, Abdallah M Samy, Juan Sanabria, Itamar S Santos, Milena M. Santric-Milicevic, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, Nizal Sarrafzadegan, Benn Sartorius, Brijesh Sathian, Thirunavukkarasu Sathish, Maheswar Satpathy, Monika Sawhney, Mehdi Sayyah, Alyssa N Sbarra, Lauren E Schaeffer, David C Schwebel, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Azadeh Shafieesabet, Amira A Shaheen, Izza Shahid, Masood Ali Shaikh, Ali S Shalash, Mehran Shams-Beyranvand, MohammadBagher Shamsi, Morteza Shamsizadeh, Mohammed Shannawaz, Kiomars Sharafi, Rajesh Sharma, Aziz Sheikh, B Suresh Kumar Shetty, Wondimeneh Shibabaw Shiferaw, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Reza Shirkoohi, K M Shivakumar, Si Si, Soraya Siabani, Tariq Jamal Siddiqi, Diego Augusto Santos Silva, Virendra Singh, Narinder Pal Singh, Balbir Bagicha Singh Singh, Jasvinder A. Singh, Ambrish Singh, Dhirendra Narain Sinha, Malede Mequanent Sisay, Eirini Skiadaresi, David L Smith, Adauto Martins Soares Filho, Mohammad Reza Sobhiyeh, Anton Sokhan, Joan B Soriano, Muluken Bekele Sorrie, Ireneous N Soyiri, Emma Elizabeth Spurlock, Chandrashekhar T Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Hafiz Ansar Rasul Suleria, Bryan L. Sykes, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Degena Bahrey Tadesse, Ingan Ukur Tarigan, Bineyam Taye, Yonatal Mesfin Tefera, Arash Tehrani-Banihashemi, Shishay Wahdey Tekelemedhin, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Berhe Etsay Tesfay, Fisaha Haile Tesfay, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Akhil Soman ThekkePurakkal, Nihal Thomas, Robert L Thompson, Alan J Thomson, Roman Topor-Madry, Marcos Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Bhaskaran Unnikrishnan, Muhammad Shariq Usman, Olalekan A Uthman, Benjamin S. Chudi Uzochukwu, Pascual R Valdez, Santosh Varughese, Yousef Veisani, Francesco S Violante, Sebastian Vollmer, Feleke Gebremeskel W/hawariat, Yasir Waheed, Mitchell Taylor Wallin, Yuan-Pang Wang, Yafeng Wang, Kinley Wangdi, Daniel J Weiss, Girmay Teklay Weldesamuel, Adhena Ayaliew Werkneh, Ronny Westerman, Taweewat Wiangkham, Kirsten E Wiens, Tissa Wijeratne, Charles Shey Wiysonge, Haileab Fekadu Wolde, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Getasew Taddesse Worku, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Mehdi Yaseri, Hiroshi Yatsuya, Alex Yeshaneh, Mekdes Tigistu Yilma, Paul Yip, Engida Yisma, Naohiro Yonemoto, Mustafa Z Younis, Hebat-Allah Salah A Yousof, Chuanhua Yu, Hasan Yusefzadeh, Siddhesh Zadey, Telma Zahirian Moghadam, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Heather J Zar, Taddese Alemu Zerfu, Yunquan Zhang, Arash Ziapour, Sanjay Zodpey, Yves Miel H Zuniga, Simon I Hay, and Robert C Reiner, Jr
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: Lymphatic filariasis is a neglected tropical disease that can cause permanent disability through disruption of the lymphatic system. This disease is caused by parasitic filarial worms that are transmitted by mosquitos. Mass drug administration (MDA) of antihelmintics is recommended by WHO to eliminate lymphatic filariasis as a public health problem. This study aims to produce the first geospatial estimates of the global prevalence of lymphatic filariasis infection over time, to quantify progress towards elimination, and to identify geographical variation in distribution of infection. Methods: A global dataset of georeferenced surveyed locations was used to model annual 2000–18 lymphatic filariasis prevalence for 73 current or previously endemic countries. We applied Bayesian model-based geostatistics and time series methods to generate spatially continuous estimates of global all-age 2000–18 prevalence of lymphatic filariasis infection mapped at a resolution of 5 km2 and aggregated to estimate total number of individuals infected. Findings: We used 14 927 datapoints to fit the geospatial models. An estimated 199 million total individuals (95% uncertainty interval 174–234 million) worldwide were infected with lymphatic filariasis in 2000, with totals for WHO regions ranging from 3·1 million (1·6–5·7 million) in the region of the Americas to 107 million (91–134 million) in the South-East Asia region. By 2018, an estimated 51 million individuals (43–63 million) were infected. Broad declines in prevalence are observed globally, but focal areas in Africa and southeast Asia remain less likely to have attained infection prevalence thresholds proposed to achieve local elimination. Interpretation: Although the prevalence of lymphatic filariasis infection has declined since 2000, MDA is still necessary across large populations in Africa and Asia. Our mapped estimates can be used to identify areas where the probability of meeting infection thresholds is low, and when coupled with large uncertainty in the predictions, indicate additional data collection or intervention might be warranted before MDA programmes cease. Funding: Bill & Melinda Gates Foundation.
Published: 2020
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36. Amphiregulin Antibody and Reduction of Axial Elongation in Experimental Myopia

Author: Wen Jun Jiang, Hui Xin Song, Shao Yu Li, Bin Guo, Jian Feng Wu, Guo Ping Li, Da Dong Guo, De Long Shi, Hong Sheng Bi, and Jost B. Jonas
Subjects: Amphiregulin, Epithelial growth factor, Experimental myopia, Axial elongation, Myopia, Medicine, Medicine (General), R5-920
Abstract: To examine the mechanism of ocular axial elongation in myopia, guinea pigs (age: 2–3 weeks) which either underwent unilateral or bilateral lens-induced myopization (group 1) or which were primarily myopic at baseline (group 2) received unilateral intraocular injections of amphiregulin antibody (doses: 5, 10, or 15 μg) three times in intervals of 9 days. A third group of emmetropic guinea pigs got intraocular unilateral injections of amphiregulin (doses: 0.25, 0.50 or 1.00 ng, respectively). In each group, the contralateral eyes received intraocular injections of Ringer's solution. In intra-animal inter-eye comparison and intra-eye follow-up comparison in groups 1 and 2, the study eyes as compared to the contralateral eyes showed a dose-dependent reduction in axial elongation. In group 3, study eyes and control eyes did not differ significantly in axial elongation. Immunohistochemistry revealed amphiregulin labelling at the retinal pigment epithelium in eyes with lens-induced myopization and Ringer's solution injection, but not in eyes with amphiregulin antibody injection. Intraocular injections of amphiregulin-antibody led to a reduction of lens-induced axial myopic elongation and of the physiological eye enlargement in young guinea pigs. In contrast, intraocularly injected amphiregulin in a dose of ≤1 ng did not show a significant effect. Amphiregulin may be one of several essential molecular factors for axial elongation.
Published: 2017
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37. Causes of vision loss worldwide, 1990–2010: a systematic analysis

Author: Dr Prof. Rupert R A Bourne, MD, Gretchen A Stevens, DSc, Richard A White, PhD, Jennifer L Smith, MSc, Seth R Flaxman, BA, Holly Price, PhD, Prof. Jost B Jonas, MD, Prof. Jill Keeffe, PhD, Janet Leasher, OD, Kovin Naidoo, PhD, Prof. Konrad Pesudovs, PhD, Prof. Serge Resnikoff, PhD, and Prof. Hugh R Taylor, MD
Subjects: Public aspects of medicine, RA1-1270
Abstract: Background: Data on causes of vision impairment and blindness are important for development of public health policies, but comprehensive analysis of change in prevalence over time is lacking. Methods: We did a systematic analysis of published and unpublished data on the causes of blindness (visual acuity in the better eye less than 3/60) and moderate and severe vision impairment ([MSVI] visual acuity in the better eye less than 6/18 but at least 3/60) from 1980 to 2012. We estimated the proportions of overall vision impairment attributable to cataract, glaucoma, macular degeneration, diabetic retinopathy, trachoma, and uncorrected refractive error in 1990–2010 by age, geographical region, and year. Findings: In 2010, 65% (95% uncertainty interval [UI] 61–68) of 32·4 million blind people and 76% (73–79) of 191 million people with MSVI worldwide had a preventable or treatable cause, compared with 68% (95% UI 65–70) of 31·8 million and 80% (78–83) of 172 million in 1990. Leading causes worldwide in 1990 and 2010 for blindness were cataract (39% and 33%, respectively), uncorrected refractive error (20% and 21%), and macular degeneration (5% and 7%), and for MSVI were uncorrected refractive error (51% and 53%), cataract (26% and 18%), and macular degeneration (2% and 3%). Causes of blindness varied substantially by region. Worldwide and in all regions more women than men were blind or had MSVI due to cataract and macular degeneration. Interpretation: The differences and temporal changes we found in causes of blindness and MSVI have implications for planning and resource allocation in eye care. Funding: Bill & Melinda Gates Foundation, Fight for Sight, Fred Hollows Foundation, and Brien Holden Vision Institute.
Published: 2013
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38. Is Kidney Function Associated with Age-Related Macular Degeneration?: Findings from the Asian Eye Epidemiology Consortium.

Author: Xue CC, Sim R, Chee ML, Yu M, Wang YX, Rim TH, Hyung PK, Woong KS, Song SJ, Nangia V, Panda-Jonas S, Wang NL, Hao J, Zhang Q, Cao K, Sasaki M, Harada S, Toru T, Ryo K, Raman R, Surya J, Khan R, Bikbov M, Wong IY, Cheung CMG, Jonas JB, Cheng CY, and Tham YC
Subjects: Humans, Male, Cross-Sectional Studies, Female, Middle Aged, Aged, Risk Factors, Asian People ethnology, Adult, Odds Ratio, Prevalence, Aged, 80 and over, Glomerular Filtration Rate, Renal Insufficiency, Chronic epidemiology, Renal Insufficiency, Chronic physiopathology, Macular Degeneration physiopathology, Macular Degeneration epidemiology
Abstract: Purpose: Chronic kidney disease (CKD) may elevate susceptibility to age-related macular degeneration (AMD) because of shared risk factors, pathogenic mechanisms, and genetic polymorphisms. Given the inconclusive findings in prior studies, we investigated this association using extensive datasets in the Asian Eye Epidemiology Consortium., Design: Cross-sectional study., Participants: Fifty-one thousand two hundred fifty-three participants from 10 distinct population-based Asian studies., Methods: Age-related macular degeneration was defined using the Wisconsin Age-Related Maculopathy Grading System, the International Age-Related Maculopathy Epidemiological Study Group Classification, or the Beckman Clinical Classification. Chronic kidney disease was defined as estimated glomerular filtration rate (eGFR) of less than 60 ml/min per 1.73 m 2 . A pooled analysis using individual-level participant data was performed to examine the associations between CKD and eGFR with AMD (early and late), adjusting for age, sex, hypertension, diabetes, body mass index, smoking status, total cholesterol, and study groups., Main Outcome Measures: Odds ratio (OR) of early and late AMD., Results: Among 51 253 participants (mean age, 54.1 ± 14.5 years), 5079 had CKD (9.9%). The prevalence of early AMD was 9.0%, and that of late AMD was 0.71%. After adjusting for confounders, individuals with CKD were associated with higher odds of late AMD (OR, 1.46; 95% confidence interval [CI], 1.11-1.93; P = 0.008). Similarly, poorer kidney function (per 10-unit eGFR decrease) was associated with late AMD (OR, 1.12; 95% CI, 1.05-1.19; P = 0.001). Nevertheless, CKD and eGFR were not associated significantly with early AMD (all P ≥ 0.149)., Conclusions: Pooled analysis from 10 distinct Asian population-based studies revealed that CKD and compromised kidney function are associated significantly with late AMD. This finding further underscores the importance of ocular examinations in patients with CKD., Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article., (Copyright © 2024 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
Published: 2024
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